我国不同管饲方式下脑卒中病人胃肠并发症发生情况的Meta分析

摘要

Objective:To systematically evaluate the occurrence of gastrointestinal complications in patients with cerebral apoplexy under nasojejunal tube and nasogastric tube feeding methods.Methods:A randomized controlled trial of gastrointestinal complications in patients with cerebral apoplexy under nasojejunal tube feeding and nasogastric tube feeding in CBM,CNKI,Wanfang,VIP database.RevMan5.3 was used to make Meta analysis of the documents that conformed to the inclusion criteria.Result:A total of 8 documents were included,with a total of 550 samples.The results were confirmed by Meta analysis:when stroke patients treated by enteral nutrition,the nasojejunal feeding could reduce the incidence of abdominal distension (OR=0.11,95％CI(0.04,0.29),P＜0.01),incidence of diarrhea[OR=0.45,95％CI(0.27,0.75),P=0.002],incidence of vomiting [OR=0.10,95％CI(0.04,0.22),P＜0.01]and food reflux rate (OR=0.14,95％CI(0.08,0.25),P＜0.01].Conclusions:When enteral nutrition support was applied to patients with cerebral apoplexy,if the gastrointestinal function of the patient was not impaired,it was recommended that the nasojejunal tube feeding should be preferred,so as to better improve the prognosis of the disease.%[目的]系统评价鼻空肠管与鼻胃管喂养方式下脑卒中病人胃肠并发症的发生情况.[方法]计算机检索中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、数字化期刊全文数据库(万方)、中文科技期刊数据库(VIP)中有关经鼻空肠管喂养与鼻胃管喂养脑卒中病人胃肠并发症发生情况的随机对照试验,运用RevMan5.3对符合纳入标准的文献进行Meta分析.[结果]共纳入8篇文献,合计样本量550例.Meta分析结果显示:脑卒中病人行肠内营养支持时,采用鼻空肠管喂养能够降低腹胀发生率[OR=0.11,95 ％CI(0.04,0.29),P＜0.01]、腹泻发生率[OR=0.45,95 ％％CI(0.27,0.75),P=0.002]、呕吐发生率OR=0.10,95％CI(0.04,0.22),P＜0.01]以及食物反流发生率[OR=0.14,95 ％CI(0.08,0.25),P＜0.01].[结论]脑卒中病人行肠内营养支持时,如病人的胃肠功能未受损,建议优先选择鼻空肠管喂养,以更好地改善疾病预后.