肠内营养补充剂防治压疮效果的系统评价  

Effect of Enteral Nutritional Supplements on Prevention and Treatment of Pressure Ulcers: A Systematic Review

作　　者：赵诗雨 柯卉 李梦圆[1] 熊璨 喻姣花[1] ZHAO Shi-yu;KE Hui;LI Meng-yuan;XlONG Can;YU Jiao-hua(Affiliated Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院,湖北武汉430022

出　　处：《护理学报》2018年第20期24-30,共7页Journal of Nursing（China）

摘　　要：目的系统评价肠内营养补充剂预防和治疗压疮的临床效果。方法计算机检索中国知网、万方数据库、中国科技期刊数据库、Cochrane library、EMbase、Web of Science、PubMed中相关的随机对照试验,检索时间均为建库至2018年3月。对文献质量进行严格评价和资料提取后,应用RevMan 5.3软件进行统计学处理。结果共纳入20篇随机对照试验研究。Meta分析结果显示:肠内营养补充剂降低了压疮发生率[RR=0.81,95%CI(0.71,0.91),P=0.0008]、提高了压疮治愈率[RR=1.53,95%CI(1.28,1.83),P<0.00001]、加快了压疮面积的缩小[SMD=-1.11,95%CI(-1.39,-0.82),P<0.00001],并且不增加患者的不良反应发生率[RR=0.78,95%CI(0.37,1.63),P=0.51],但不能加快压疮愈合计分的降低[MD=-0.68,95%CI(-1.47, 0.1),P=0.09]。结论肠内营养补充剂在降低压疮发生率、提高压疮治愈率和加快压疮面积缩小方面具有优越性,具不会增加不良反应的发生率,但其在促进压疮愈合计分的下降、缩短压疮愈合时间方面的效果还不能确定,还需高质量、大样本的随机对照试验予以进一步验证。Objective To systematically evaluate the clinical effects of enteral nutrition supplements on the prevention and treatment of pressure ulcers. Methods Randomized controlled trials （RCTs） were retrieved from CNKI, WanFang database, VIP, Cochrane Library, Medline, EMbase, Web of Science and PubMed. RevMan 5.3 software was used for statistical analysis after the literature quality was evaluated strictly and the data was extracted. Results Twenty RCTs were included. Meta-analysis showed that enteral nutrition supplements could reduce the incidence of pressure ulcers [RR=0.81,95%CI（0.71,0.91）, P=0.0008], improve the cure rate of pressure ulcer [RR=1.53,95%CI（1.28,1.83）, P〈0.00001] and reduce pressure ulcer area [SMD=-1.11,95%CI（-1.39,-0.82）,P〈0.00001] without increasing the incidence of adverse reactions [RR=0.78,95%CI（0.37,1.63）, P=0.51] but it could not reduce the healing score of pressure ulcers [MD=-0.68,95%CI（-1.47, 0.1）, P=0.09]. Conclusion Enteral nutrition supplements have advantages in reducing the incidence of pressure ulcer, improving the cure rate of pressure ulcer and reducing the area of pressure ulcer,while the effect of reducing pressure ulcer healing score and shortening the healing time and whether increasing the incidence of adverse reactions is still not certain. Large and high-quality randomized controlled trials are needed to confirm its effect.

关 键 词：肠内营养 营养补充剂 压疮 系统评价 

分 类 号：R248.1[医药卫生—中医临床基础]