摘要目的 评价术后早期经口进食对胃肠道手术患者术后恢复的影响.方法 采用Meta分析的方法,检索CNKI,China Biology Medicine database(CBM),PubMed,Embase,The Cochrane Library,Web of Science数据库,收集2006—2016年所有相关的临床随机对照试验,并筛选纳入文献的参考文献.运用RevMan 5.3软件进行数据处理.结果 共纳入11篇随机对照试验,包括2188例患者.结果显示,术后早期经口进食组与传统禁食组相比,术后恢复排气时间[MD=-0.90 d,95%CI(-1.12,-0.67),P<0.05],术后恢复排便时间[MD=-0.89 d,95%CI(-1.11,-0.79),P<0.05],术后鼻胃管重置发生率[RR=0.57,95%CI(0.36,0.90)],术后恢复饮食时间[RR=0.57 d,95%CI(0.36,0.90)],感染性并发症发生率[RR=0.45,95%CI(0.28,0.74)],差异均有统计学意义(P<0.05);而呕吐[RR=1.44,95%CI(0.69,3.19)],腹胀[RR=1.29,95%CI(0.70,2.36)],术后并发症总体发生率[RR=0.82,95%CI(0.59,1.15)],非感染性并发症[RR=0.78,95%CI(0.49,1.25)],差异无统计学意义(P>0.05).结论 早期经口进食有利于消化系统疾病患者的消化道功能恢复,对减少感染性并发症的效果显著.

abstractsObjective To evaluate the effects of early oral feeding on postoperative recovery of patients undergoing gastrointestinal surgery.Methods CNKI, China Biology Medicine database (CBM), PubMed, Embase, The Cochrane Library and Web of Science databases were screened. Randomized controlled trials (RCTs) and their references from 2006 to 2016 were recruited using Meta-analysis. RevMan 5.3 software was used for data processing.Results A total of 11 RCTs containing 2188 patients were included in the study. In patients with early oral feeding compared to patients with traditional fasting, there were statistically significant differences in first time of flatus [MD=-0.90 d, 95%CI (-1.12, -0.67),P<0.05], first time of stools [MD= -0.89 d, 95%CI (-1.11, -0.79),P<0.05], nasogastric tube reinsertion rate [RR=0.57, 95%CI (0.36, 0.90), P<0.05], fist time of regular diet [RR=0.57 d, 95%CI (0.36, 0.90),P<0.05], and infective complications rate [RR=0.45, 95%CI (0.28, 0.74),P<0.05]; No significant differences were observed for vomiting [RR=1.44, 95%CI (0.69, 3.19),P>0.05], abdominal distension [RR=1.29, 95%CI (0.70, 2.36),P>0.05], the total incidence rate of postoperative complications [RR=0.82, 95%CI (0.59, 1.15),P>0.05]and non-infective complications [RR=0.78, 95%CI (0.49, 1.25),P>0.05].Conclusions Early oral feeding is beneficial to the recovery of gastrointestinal function in patients with digestive system diseases, and significantly reduces the infective complications.