背景:在肠内营养护理中是否有必要监测胃残量存在诸多争议。我们旨在进行更新的荟萃分析,以评估监测或不监测胃残余量对患者预后和并发症的影响。
方法:我们在2021年4月15日的CochraneLibrary数据库中搜索了关于胃残余体积和无胃残余体积监测影响的随机对照试验(RCT)。使用ReviewManager软件进行数据分析。
结果:共纳入7项RCT,涉及1240例肠内营养患者。胃残余量监测与呕吐发生率降低相关(OR2.33,95%CI:1.68-3.24),而无胃液残留量监测与肠内营养不必要中断发生率降低相关(OR0.38,95%CI:0.26~0.55).腹胀发生率无显著差异(OR1.87,95%CI:0.82-4.28),腹泻(OR1.03,95%CI:0.74-1.43),VAP(OR0.83,95CI:0.37-1.89),机械通气持续时间(MD-0.06,95%CI:-1.22-1.10),ICU住院时间(MD-1.33,95%CI:-3.58-0.91)和死亡率(OR0.90,95%CI:0.61-1.34)。
结论:不监测胃残留量与减少不必要的肠内营养中断有关,这些中断与喂养不足和呕吐风险增加有关。
BACKGROUND: There are many controversies over the necessity of monitoring gastric residual volume in the nursing care of enteral nutrition. We aimed to conduct an updated meta-analysis to evaluate the effects of monitoring or not monitoring gastric residual volume on patients\' outcomes and complications.
METHODS: We searched the Cochrane Library database to 15 April 2021 for randomized controlled trials (RCTs) on the effects of gastric residual volume and no gastric residual volume monitoring.
Review Manager software was used for data analysis.
RESULTS: A total of seven RCTs involving 1240 enteral nutrition patients were included. Gastric residual volume monitoring was associated with reduced incidence of vomiting (OR2.33, 95% CI:1.68-3.24), whereas no gastric residual volume monitoring was associated with reduced incidence of unnecessary interruptions of enteral nutrition (OR0.38,95% CI:0.26-0.55). There were no significant differences on the incidence of abdominal distention (OR1.87, 95% CI:0.82-4.28), diarrhoea (OR1.03,95% CI:0.74-1.43), VAP (OR0.83, 95%CI:0.37-1.89), duration of mechanical ventilation (MD -0.06,95% CI:-1.22-1.10), length of ICU stay (MD -1.33, 95% CI:-3.58-0.91) and mortality (OR0.90,95% CI:0.61-1.34).
CONCLUSIONS: Not monitoring gastric residual volume is associated with reduced unnecessary interruptions of enteral nutrition related to inadequate feeding and increased risk of vomiting.