体位干预对胃镜检查中胃内黏膜清晰度影响的网状Meta分析  

The effect of posture intervention on intragastric mucosal clarity in gastroscopy:a network meta-analysis

作　　者：吴冰冰 陈泽鑫[1] 李祥云 方良玉[1] 吴美凤[1] 叶永琍[1] Wu Bingbing;Chen Zexin;Li Xiangyun;Fang Liangyu;Wu Meifeng;Ye Yongli(The Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou Zhejiang 310009,China;Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine,Hangzhou Zhejiang 310020,China)

机构地区：[1]浙江大学医学院附属第二医院,浙江杭州310009 [2]浙江大学医学院附属邵逸夫医院,浙江杭州310020

出　　处：《护理与康复》2023年第11期14-23,共10页Journal of Nursing and Rehabilitation

基　　金：浙江省医药卫生科技计划一般项目,编号2023KY108;浙江省青年基金项目,编号LQ19H040015。

摘　　要：目的采用网状Meta分析评价胃镜检查过程中不同体位干预方式对胃镜下胃内黏膜清晰度和检查时间的影响。方法检索国内外数据库以及相关学会网站中关于胃镜检查前服用祛泡剂、祛黏液剂后体位改变对胃镜检查中胃内黏膜清晰度影响的文献,同时追溯参考文献并手动检索相关灰色文献,检索时限为建库至2023年3月。经文献筛选、质量评价、资料提取后,采用Stata 13.0软件进行统计分析。结果本研究共纳入13篇随机对照试验研究,包含11978例患者,涉及14种体位干预措施。网状Meta分析结果显示,右侧卧位-仰卧位-左侧卧位各5 min在胃内黏膜清晰度方面优于无特殊体位改变、同一方向翻滚1~3周、左侧卧位-仰卧位-右侧卧位-俯卧位重复4~5次、仰卧位-左侧卧位-俯卧位-右侧卧位各保持30~60 s重复3~4轮和小于180°的体位改变,在胃镜检查时间方面优于无特殊体位改变。根据累积排序概率曲线下面积排序结果,右侧卧位-仰卧位-左侧卧位各5 min可能是改善胃内黏膜清晰度和缩短检查时间的最佳体位干预方式。结论体位干预可以有效改善胃镜检查下胃内黏膜清晰度并缩短检查时间,尤其以右侧卧位-仰卧位-左侧卧位各5 min效果最好。Objective To evaluate the effects of different postural intervention modalities during gastroscopy on endoscopic intragastric mucosal clarity and examination time by network meta-analysis.Methods To search the domestic and internaticnal database,as well as some websites of gastrointestinal endoscopy society for information on the effects of gastroscopy on the resolution of gastric mucosa by changing of body position after taking defoamer and mucus repellent.Retrieve references and manually retrieve relevant gray documents at the same time.The retrieval period is until March 2023.After literature screening,quality assessment,and data extraction,statistical analysis was performed using Stata 13.0 software.Results A total of 13 randomized controlled trial studies were included in this study,containing 11978 patients and involving 14 postural interventions.The results of network meta-analysis showed that right lateral-supine-left lateral position for 5 min each was superior to positional changes with no specific positional changes,rolling in the same direction for 1 to 3 weeks,left lateral-supine-right lateral-pronation repeated 4 to 5 times,and maintaing supine position,left lying position,prone position,and riglit lying position for 30-60 seconds for 3-4 rounds and<180°,respectirely.According to the results of the area under the cumulative sorting probability curve,the right-supine-left-supine position for 5 min each may be the best positional intervention to improve the clarity of the intragastric mucosa and shorten the examination time.Conclusion Positional intervention can effectively improve the clarity of the gastric mucosa and shorten the examination time under gastroscopy,especially the right lateral recumbent position-supine position-left lateral recumbent position for 5 min each is the most effective.

关 键 词：体位干预 胃镜 黏膜清晰度 META分析 

分 类 号：R473.57[医药卫生—护理学]