摘要
目的 :通过系统评价研究不留置胃管或术后早期拔除胃管对择期肝切除术后康复效果的影响。方法:检索PubMed、WebofScience、CochraneLibrary、CNKI、WanfangData和CBM数据库,检索时间为建库至2019年2月。由两名研究者按照纳入排除标准筛选RCT研究并提取数据,最后利用RevMan 5.3软件进行Meta分析。结果 :纳入研究共11篇,1 668例患者,观察组826例,对照组842例。Meta分析结果显示,与肛门排气后拔除胃管相比,不留置胃管或早期拔除胃管(≤24 h)可降低术后咽喉疼痛和肺部并发症发生率(OR=0.16,95%CI=0.10~0.23,P<0.05;OR=0.57,95%CI=0.40~0.81,P<0.05)。术后腹胀(OR=0.90,95%CI=0.65~1.23,P>0.05)、恶心、呕吐(OR=0.72,95%CI=0.40~1.30,P>0.05)和其他手术并发症发生率(OR=0.76,95%CI=0.58~1.00,P=0.05)虽低于对照组,但差异无统计学意义。两组患者术后肛门排气时间(WMD=-5.41,95%CI=-14.39~3.57,P>0.05)、进食时间(WMD=-15.69,95%CI=-33.17~1.79,P>0.05)和术后住院时间(WMD=-0.42,95%CI=-0.86~0.01,P>0.05)差异无统计学意义。结论 :择期肝切除术患者术后不留置胃管或早期拔除胃管是安全的,可降低术后肺部并发症的发生率,提高患者舒适度。
Objective:To investigate the effect of no nasogastric intubation during operation or early removal of nasogastric intubation after operation for patients with elective hepatectomy.Methods:The database of the PubMed,Web of Science,Cochrane Library,CNKI,Wanfang Data and CBM database were screened by two researchers.The Meta-analysis was performed using RevMan5.3 software.Results:A total of 11 articles were included in the study.Totally 826 patients with no nasogastric tube during operation or removal of nasogastric tube within 24 hours after operation were included in the observation group,while 842 with nasogastric tube removal after anal exhaustion were included in the control group.The incidence of postoperative throat pain and pulmonary complications in the observation group were significantly lower than the control group respectively(OR=0.16,95%CI=0.10-0.23,P<0.05;OR=0.57,95%CI=0.40-0.81,P<0.05).The incidences of postoperative abdominal distention(OR=0.90,95%CI=0.65-1.23,P>0.05),nausea and vomiting(OR=0.72,95%CI=0.40-1.30,P>0.05)and other surgical complications(OR=0.76,95%CI=0.58-1.00,P=0.05)in the observation group were less than the control group,but the differences between the two groups were not statistically different.There were no significant differences between the two groups in postoperative anal exhaust time,feeding time and postoperative hospitalization time.Conclusion:For patients with elective hepatectomy,it seems feasible to have no nasogastric tube during operation or early removal of the nasogastric tube after operation.
作者
张有娣
蒲小金
翟田田
汪袁云子
周文策
ZHANG Youdi;PU Xiaojin;ZHAI Tiantian;WANG Yuanyunzi;ZHOU Wence(School of Nursing,Lanzhou University,Lanzhou,730000,China)
出处
《中国护理管理》
CSCD
北大核心
2019年第9期1411-1417,共7页
Chinese Nursing Management
关键词
肝切除术
胃管
胃肠减压
META分析
hepatectomy
nasogastric intubation
gastrointestinal decompression
Meta-analysis
