摘要
目的:分析鼻胃管与鼻肠管2种肠内营养方式在重症急性胰腺炎中的有效性及安全性。方法:检索PubMed、the Cochrane Library、EMbase、MedLine、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中关于经鼻胃管与经鼻肠管2种肠内营养方式治疗重症急性胰腺炎的随机对照研究。检索时限为建库至2022年5月。由2名研究者独立进行文献筛选、资料提取和质量评价,运用RevMan 5.4软件进行Meta分析。结果:共纳入10篇文献,涉及596例病人,其中鼻肠管组300例,鼻胃管组296例。鼻肠管组C-反应蛋白水平[MD=4.66,95%CI(2.31,7.00),Z=3.89,P=0.000 1]、并发症发生率[OR=1.57,95%CI(1.01,2.41),Z=2.03,P=0.04]低于鼻胃管组。两组血清清蛋白[MD=-0.62,95%CI(-1.69,0.45),Z=1.13,P=0.26]、住院时间[MD=-0.43,95%CI(-1.33,0.47),Z=0.94,P=0.35]、死亡率[OR=0.56,95%CI(0.25,1.23),Z=1.44,P=0.15]比较,差异无统计意义。结论:现有证据表明,经鼻胃管与经鼻肠管肠内营养的效果相似,但在缓解炎症反应和降低并发症发生率方面鼻肠管优于鼻胃管。
Objective:To analyze the efficacy and safety of nasogastric tube and nasointestinal tube in the treatment of severe acute pancreatitis.Methods:Randomized controlled studies on the treatment of severe acute pancreatitis with enteral nutrition via nasogastric tube and nasogastric tube were retrieved from PubMed,the Cochrane Library,EMbase,MedLine,CNKI,WanFang Database,VIP and CBM.The search period was from the establishment of the database to May 2022.Literature screening,data extraction and quality evaluation were conducted independently by two researchers.Meta-analysis was performed using RevMan 5.4 software.Results:A total of 10 articles were included,involving 596 patients,including 300 cases in the nasointestinal tube group and 296 cases in the nasogastric tube group.The level of C-reactive protein[MD=4.66,95%CI(2.31,7.00),Z=3.89,P=0.0001]and complication rate[OR=1.57,95%CI(1.01,2.41),Z=2.03,P=0.04]in nasointestinal tube group were lower than those in nasogastric tube group.There was no significant difference in serum albumin[MD=-0.62,95%CI(-1.69,0.45),Z=1.13,P=0.26],length of hospital stay[MD=-0.43,95%CI(-1.33,0.47),Z=0.94,P=0.35]and mortality[OR=0.56,95%CI(0.25,1.23),Z=1.44,P=0.15]between the two groups.Conclusion:Existing evidence suggests that the effectiveness of enteral nutrition through nasogastric tubes is similar to that through nasointestinal tubes,but nasointestinal tubes are superior in alleviating inflammatory reactions and reducing the incidence of complications.
作者
陈丽颖
王秀锋
高娅妮
王亚珍
CHEN Liying;WANG Xiufeng;GAO Yani;WANG Yazhen(Gansu University of Chinese Medicine,Gansu 730050 China)
出处
《循证护理》
2023年第10期1718-1722,共5页
Chinese Evidence-Based Nursing
基金
甘肃省自然科学基金项目,编号:22JR5RA015。
关键词
重症急性胰腺炎
肠内营养
鼻胃管
鼻肠管
META分析
循证护理
severe acute pancreatitis
enteral nutrition
nasogastric tube
nasointestinal tube
Meta-analysis
evidence-based nursing
