检索历史 清除

目的 系统评价危重患者早期肠内营养支持最佳剂量的选择.方法 检索PubMed、Web of Science、Scopus、CINAHL、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方等数据库中危重患者肠内营养支持剂量选择相关的随机对照研究.由2名研究人员按照纳入、排除标准筛选文献,采用Cochrane系统评价手册偏倚风险评估标准对文献质量进行评价,并提取资料,采用RevMan5.3软件进行Meta分析.结果 共检索1 571篇文献,最终纳入8项RCT研究,共2 713例研究对象.Meta分析结果显示,滋养型喂养和全喂养相比,机械通气时间、腹泻发生率、胃动力药物使用率方面差异有统计学意义(P＜0.05);在病死率、住院时间、院内感染发生率、反流、呕吐、便秘等方面差异无统计学意义(P＞0.05).结论 滋养型喂养相比全喂养在病死率、住院时间等方面并未表现出优势,但有助于缩短ICU患者的机械通气时间,改善胃肠道耐受性,考虑到纳入研究的局限性,临床应用需谨慎.

Objective To systematically evaluate the optimal dose of early enteral nutrition support in critically ill patients.Methods Systematic search database including PubMed,Web of science,Scopus,CINAHL,CBM,CNKI.RCTs about early enteral nutrition dose selections in critically ill patients were chosen according to include and exclude criteria by two researchers independently.Cochrane system evaluation manual bias risk assessment was used to evaluate quality of literature.RevMan5.3 Meta analysis software was used to analyze the data.Results A total of 1 571 literatures were retrieved and 8 RCT studies were included,2 713 subjects in total.Meta analysis results showed that there were statistically significant differences in mechanical ventilation time,incidence of diarrhea,and utilization rate of gastro dynamic drugs between trophic feeding and full feeding (P＜0.05).There were no statistically significant differences in mortality,length of stay,incidence of nosocomial infections,reflux,vomiting,constipation,etc.(P＞0.05).Conclusions Trophic feeding has familiar effects on mortality,length of hospital stay compared to full feeding,but it can help to shorten ICU mechanical ventilation time,improve the gastrointestinal tolerability.