间断喂养与持续喂养对危重症病人肠内营养耐受性影响的Meta分析  

Effects of intermittent and continuous feeding on enteral nutritional tolerance in critically ill patients:a Meta-analysis

作　　者：李阳洋 邵小平 蒋卓娟 俞荷花 雷培培 LI Yangyang;SHAO Xiaoping;JIANG Zhuojuan;YU Hehua;LEI Peipei(Changzheng Hospital Affiliated to Navy Medical University,Shanghai 200003 China)

机构地区：[1]海军军医大学附属长征医院,上海200003

出　　处：《护理研究》2020年第8期1383-1387,共5页Chinese Nursing Research

摘　　要：[目的]系统评价间断喂养、持续喂养对危重症病人肠内营养耐受性的影响。[方法]计算机检索Cochrane Library、PubMed、Ovid Medline、EMbase、中国生物医学文献服务系统(CBM)、维普数据库(VIP)、中国期刊全文数据库(CNKI)以及万方数据库,搜索建库至2019年4月1日所有关于采用间断喂养及持续喂养对危重症病人肠内营养耐受性影响的临床对照研究,筛选纳入研究的参考文献。由2名研究生对文献质量进行严格评价及资料提取,使用RevMan 5.5软件进行Meta分析。[结果]共纳入7篇文献,3篇为随机对照试验研究,4篇为临床对照试验。Meta分析结果显示:间断喂养与持续喂养对危重症病人肠内营养并发症腹胀[OR=1.43,95%CI(0.68,3.04)]、腹泻[OR=1.15,95%CI(0.69,1.92)]的发生率比较差异无统计学意义(P>0.05);重症病人肠内营养目标供给量达标情况[OR=2.67,95%CI(1.69,4.23)]比较差异有统计学意义(P<0.05)。[结论]现有证据表明,间断喂养更符合正常人的生理,不会增加腹泻、腹胀发生率;且可提高危重症病人肠内营养目标供给量达标率。Objective:To systematically evaluate the effects of intermittent feeding and continuous feeding on enteral nutritional tolerance in critically ill patients.Methods:Controlled clinical studies related to effects of intermittent feeding and continuous feeding on enteral nutrition tolerance of critically ill patients were retrieved from following databases:the Cochrane Library,PubMed,Ovid Medline,EMbase,Chinese biomedical literature service system(CBM),Weipu database(VIP)Chinese national knowledge infrastructure(CNKI),and Wanfang database.The retrieval time was from the establishment of databases to Aprili,2019.And references of included studies were screened.Evaluation of literature quality and data extraction were carried out by two graduate students strictly.And Meta analysis was performed using RevMan 5.5 software.Results:A total of 7 literatures were included,involving 3 randomized controlled trials and 4 clinical controlled trials.Meta-analysis results showed that there were no statistically significant differences between intermittent feeding and continuous feeding on the incidences of abdominal distension[OR=1.43,95%CI(0.68,3.04)]and diarrhea[OR=1.15,95%CI(0.69,1.92)]of complications of inenteral nutrition in critically ill patients(P>0.05).There was stastical differences in the failure to meet target supply of enteral nutrition target in critically ill patients between two methosd[OR=2.67,95%CI(1.69,4.23)]was statistically significant(P<0.05).Conclusion:Current evidence shows that intermittent feeding is more situable for normal physiology.And it does not increase the incidences of diarrhea and abdominal distension.In addition,intermittent feeding can also improve rate of metting target supply of enteral nutrition in critically ill patients.

关 键 词：重症监护病房 肠内营养 持续喂养 间断喂养 顿服 耐受性 系统评价 

分 类 号：R47[医药卫生—护理学]