中西医结合护理 (Aug 2023)
Effects of intermittent oral-esophageal tube feeding for patients with post-stroke dysphagia: A Meta-analysis (间歇性经口至食管管饲用于脑卒中后吞咽障碍患者疗效的Meta分析)
Abstract
Objective To evaluate the effects of intermittent oral-esophageal tube feeding for patients with post-stroke dysphagia. Methods Researches had searched CNKI, Wanfang Database, VIP, CBM, PubMed, Web of Science, Embase, The Cochrane Library, Scopus, OVID and CINAHL, and references of included studies were searched, from inception to June 2022. Two trained researchers independently screened the literature, evaluated the quality and extracted the data according to the standard. RevMan 5. 4 was used for Meta-analysis. Results A total of 14 studies with 1041 patients were included. The results of meta-analysis showed that intermittent oral-esophageal tube feeding group was better than the nasal indwelling gastric tube feeding group in improving swallowing function and nutritional index, and reducing the incidence of aspiration and aspiration pneumonia(P＜0. 01). Conclusion Intermittent oral-esophageal tube feeding can effectively improve swallowing function and nutritional status in patients with dysphagia after stroke, and reduce the incidence of aspiration and aspiration pneumonia. However, how to apply it safely and effectively in clinical practice still needs large samples, multi-center, high-quality studies and high-level evidence for clinical application. (目的 评价间歇性经口至食管管饲在脑卒中后吞咽障碍患者中的干预效果。方法 计算机检索中国知网(CNKI)、万方(Wanfang Data)、维普(VIP)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、Embase、The Cochrane Library、Scopus、OVID、CINAHL等数据库, 对纳入文献的参考文献使用滚雪球的方式进行全面追查。检索时间为建库至2022年6月22日。由两名经过培训的研究者按照标准独立筛选文献、质量评价和提取资料。采用RevMan5. 4软件对纳入文献进行Meta分析。结果 共纳入14篇文献, 总样本量为1041例。Meta分析结果显示, 间歇性经口至食管管饲组在改善患者吞咽功能和营养指标方面均优于留置鼻胃管组, 且能降低误吸和吸入性肺炎的发生率, 差异有统计学意义(P＜0. 01)。结论 脑卒中后吞咽障碍患者使用间歇性经口至食管管饲能有效改善吞咽功能和营养状况, 降低误吸、吸入性肺炎等并发症的发生率。然而, 如何安全有效将其应用于临床, 仍需大样本、多中心的高质量研究和高级别证据来进一步证实。)
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