鼻胃管与鼻空肠管营养对重症急性胰腺炎耐受性及预后影响的Meta分析  

Meta analysis on the tolerance and prognosis of nasogastric feeding versus nasojejunal feeding in severe acute pancreatitis

作　　者：李文桃 杨冲[1] 赵冀[1] 张宇[1] 朱世凯[1] 陈凯[1] 杨洪吉[1] 

机构地区：[1]四川省医学科学院四川省人民医院器官移植中心,成都610072

出　　处：《中华胰腺病杂志》2016年第6期383-388,共6页Chinese Journal of Pancreatology

摘　　要：目的比较鼻胃管（NG）与鼻空肠管（NJ）营养对重症急性胰腺炎（SAP）患者的安全性及有效性。方法以鼻胃管、鼻空肠管、SAP、肠内营养为检索词，系统检索PubMed、EMbase、Cochrane Library、万方和中国知网数据库的文献，检索时间截止2016年6月。应用随机效应模型进行Meta分析。结果5篇随机对照试验文献共264例患者（136例NG组和128例NJ组）纳入研究，两组患者的不良事件发生率[病死率（RR=0．77，95％CI0．42—1．41，P=0．39）、感染发生率（RR=0．77，95％CI0．45～1．30，P=0．39）、消化道不良反应发生率（RR=1．26，95％CI0．73—2．16，P=0．41）、停止鼻饲比例（RR=0．66，95％CI0．10～4．10，P=0．65）、MODS发生率（RR=0．98，95％CI0．71—1．35,P=0．90）]、能量平衡比例（RR=1．00，95％CI0．97～1．03，P=0．39）、平均住院时间（RR=0．98，95％CI0．71～1．35，P=0．90）的差异均无统计学意义。结论NG与NJ营养对SAP患者的安全性及有效性效果相当，但NG营养操作更为简便，有更高的临床应用价值。Objective To compare the safety and efficiency of nasogastric （NG） feeding with nasojejunal （NJ）feeding in treating severe acute pancreatitis （SAP）. Methods The terms ＂NG tube＂, ＂NJ tube＂, ＂SAP＂ and ＂enteral nutrition＂ were used for literature search in PubMed, Embase, Cochrane Library, WanFang and CNKI databases and the publication deadline was June 1, 2016. Random effect model was used for Meta analysis. Results A total of 5 random clinical trials involving 264 patients （ 136 in NG group and 128 in NJ group） were included. There was no statistical difference on the incidence of adverse events （ mortality： RR = 0.77, 95 % CI 0. 42 - 1.41, P = 0.39 ; infection complications ： RR = 0.77, 95 % CI 0.45- 1.30, P=0.39; digestive complications： RR=1.26, 95% CI 0.73- 2.16, P=0.41; stopping nasogastric proportion： RR =0.66, 95% CI O. 10 -4.10, P =0.65 ; MODS rate： RR =0.98, 95% CI 0. 71 - 1.35, P=0.90; the percentage of energy balance： RR=1.00, 95% CI 0.97-1.03, P=0.39 and the average length of hospital stay： RR=0.98, 95%CI0.71 -1.35, P=0.90）. Condusions NG feeding was safe and effective, which was comparable with NJ feeding. NG feeding was more convenient with a higher clinical value.

关 键 词：胰腺炎 急性坏死性 肠道营养 自身耐受性 插管法 胃肠 

分 类 号：R657.51[医药卫生—外科学]