摘要
目的系统评价早期肠内营养(early enteral nutrition,EEN)应用于ICU机械通气患者的效果,为重症患者营养支持提供循证依据。方法应用计算机检索PubMed数据库、Cochrane Library、Web of Knowledge、中国知网(CNKI)、万方数据库和维普中文科技期刊数据库(VIP)中关于比较EEN与肠外营养(parenteral nutrition,PN)对ICU机械通气患者的随机对照试验。两名研究者对满足纳入标准的文献采用RevMan5.3统计软件进行Meta分析。结果共纳入11篇文献,其中4篇英文文献,7篇中文文献,共5574例患者。经Meta分析结果显示,与PN相比,EEN能够降低患者肺部感染发生率[OR=0.74,95%CI=0.59~0.92,P<0.01];消化道出血发生率[OR=0.33,95%CI=0.18~0.60,P<0.01],但EEN在降低血流感染[OR=0.80,95%CI=0.59~1.08,P=0.14]、腹泻发生率[OR=0.43,95%CI=0.17~1.06,P=0.07]及病死率[OR=0.94,95%CI=0.84~1.06,P=0.3]方面并未显示明显优势,合并效应无统计学意义(P>0.05)。结论ICU患者行EEN对其血流感染、腹泻发生率及病死率无明显影响,其肺部感染及消化道出血发生率降低。
Objective To evaluate the effect of early enteral nutrition(EEN)on mechanical ventilation in ICU patients so as to provide evidence-based evidence for nutritional support for critically ill patients.Methods The literature on randomized controlled trial for comparing EEN and parenteral nutrition(PN)in ICU patients was retrieved through PubMed database,Cochrane Library,Web of Knowledge,CNKI,Wanfang database and VIP.The data from the included papers in accordance with the inclusion and exclusion criteria treated on RevMan5.3 for meta-analysis.Results A total of 11 papers were included,covering 4 English and 7 Chinese ones,involving a total of 5,574 patients.By the meta-analysis,compared with PN,EEN reduced the incidences of lung infection and gastrointestinal bleeding[OR=0.74,95%CI=0.59~0.92,P<0.01;OR=0.33,95%CI=0.18~0.60,P<0.01,respectively],but EEN was not superior in reducing bloodstream infection[OR=0.80,95%CI=0.59~1.08,P=0.14],diarrhea incidence[OR=0.43,95%CI=0.17~1.06,P=0.07]and mortality[OR=0.94,95%CI=0.84~1.06,P=0.3].The combined effect was not statistically significant(P>0.05).Conclusion EEN in the ICU patients has no significant effect on bloodstream infection,diarrhea and mortality,but it can reduce the incidence of pulmonary infection and gastrointestinal bleeding.
作者
江丽玲
王建宁
李立群
张淑
Jiang Liling;Wang Jianning;Li Liqun;Zhang Shu(Graduate School,Nanchang University,Nanchang,330000,China;The First Affiliated Hospital,Nanchang University,Nanchang,330000,China)
出处
《现代临床护理》
2020年第6期27-34,共8页
Modern Clinical Nursing
