持续性鼻饲喂养对重症患者吸入性肺炎及相关症状影响的Meta分析  

Meta-analysis of the effects of continuous nasal feeding on aspiration pneumonia and related symptoms in critically ill patients

作　　者：孙超[1] 王贞慧[1] 王霞[1] 蔡虻[2] Sun Chao;Wang Zhenhui;Wang Xia;Cai Meng(Department of Nursing,Beijing Hospital,National Center of Geriatrics,Institute of Geriatrics,Chinese Academy of Medical Sciences,Beijing 100730,China;Division of Hospital Infection Management,Beijing Hospital,National Center of Geriatrics,Institute of Geriatrics,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院护理部,国家老年医学中心,中国医学科学院老年医学研究院,100730 [2]北京医院医院感染管理处,国家老年医学中心,中国医学科学院老年医学研究院,100730

出　　处：《中华现代护理杂志》2020年第13期1698-1703,共6页Chinese Journal of Modern Nursing

基　　金：中美新发和再发传染病合作项目(5U2GGH000018);北京医院“科技新星”项目(BJ-2018-129)。

摘　　要：目的评价持续性鼻饲喂养对重症患者吸入性肺炎及相关症状发生情况的影响。方法采用Cochrane系统评价方法,计算机检索相关文献,数据库选择PubMed、Web of Science、ScienceDirect、中国生物医学文献数据库、万方数据库、知网。中文为2000年1月—2018年11月,英文为从建库至2018年11月,进行文献质量评价后,采用RevMan 5.3对符合纳入标准文献进行Meta分析。结果共纳入10篇随机对照试验,Meta分析效应量合并的结果显示,持续性鼻饲喂养能够有效降低吸入性肺炎(10项研究,100%)、胃潴留(4项研究,40%)、呕吐(3项研究,30%)、误吸(3项研究,30%)的发生。结论持续性鼻饲喂养能够降低吸入性肺炎及相关症状的发生。纳入文献中的具体喂养方案不完全一致,研究存在一定的异质性,尚需更多高质量、大样本、设计严谨的临床试验去检验持续性鼻饲喂养对预防吸入性肺炎及相关症状的预防效果。Objective To evaluate the effects of continuous nasal feeding on aspiration pneumonia in critically ill patients.Methods The Cochrane systematic reviews were used to retrieve relevant articles by computer.In this study,PubMed,Web of Science,ScienceDirect,Chinese Biomedical Literature Database,Wanfang Database and CNKI were selected.Chinese articles published from January 2000 to November 2018,and English articles published up to November 2018 were retrieved.After the quality of the articles was evaluated,RevMan 5.3 was used to conduct a meta-analysis over the articles that met the inclusion criteria.Results A total of 10 randomized controlled trials were included.The combined results of metaanalysis showed that continuous nasal feeding could effectively reduce the incidence of aspiration pneumonia(10 studies,100%),gastric retention(4 studies,40%),vomiting(3 studies,30%),and aspiration(3 studies,30%).Conclusions Continuous nasal feeding can reduce the occurrence of aspiration pneumonia and related symptoms.The specific feeding programs included in the articles are not completely consistent,and there are certain heterogeneities in the studies.More high-quality,large-sample,and rigorously designed clinical trials are still needed to test the preventive effects of continuous nasal feeding on aspiration pneumonia.

关 键 词：重症 鼻饲喂养 持续性喂养 吸入性肺炎 META分析 

分 类 号：R563[医药卫生—呼吸系统]