■术后肠梗阻是一种常见的疾病,导致并发症和更长的住院时间。很少有研究证明早期口服喂养在预防胃肠道手术后肠梗阻方面的益处。这项研究旨在评估早期与延迟口服喂养对肠道运动恢复的疗效。住院时间,和并发症。
■我们对随机对照试验进行了系统评价和荟萃分析,搜索PubMed,Embase,护理和相关健康文献的累积指数,Cochrane中央控制试验登记册,和ClincalTrials.gov,直到2022年12月31日。我们评估了粪便的第一次通过,第一次肠胃气胀,并发症,术后住院时间,和呕吐。我们使用Cochrane偏倚风险工具(第2版)评估了随机试验的偏倚风险,并使用建议评估等级评估的证据质量。发展,和评价方法。
■我们纳入了34项研究,中位样本量为102名参与者。在证据适度确定的情况下,早期经口喂养可缩短首次排便时间(MD-0.99天;CI95%-1.25,-0.72),首次排气(MD-0.70天;CI95%-0.87,-0.53),和并发症的风险(RR0.69;CI95%0.59-0.80),虽然证据的确定性很低,它可能会缩短住院时间(MD-1.31天;CI95%-1.59,-1.03)。然而,早期进食可能不会影响呕吐风险(RR0.90;CI95%0.68,1.18).
■这篇综述表明,胃肠道手术后早期口服喂养可能会导致肠道恢复更快,术后住院时间较短,更少的并发症。然而,由于高度异质性和证据的中低质量,因此需要仔细解释.未来的研究应集中在早期口服喂养的类型和开始时间上。
UNASSIGNED: Postoperative
ileus is a frequent condition, leading to complications and a longer hospital stay. Few studies have demonstrated the benefit of early oral feeding in preventing
ileus after gastrointestinal surgery. This study aims to evaluate the efficacy of early versus delayed oral feeding on the recovery of intestinal motility, length of hospital stay, and complications.
UNASSIGNED: We conducted a systematic review and meta-analysis of randomized control trials, searching PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, and the ClincalTrials.gov until 31 December 2022. We evaluated the first passage of the stool, the first flatus, complications, length of postoperative stay, and vomiting. We assessed the risk of bias using the Cochrane risk of bias tool (version 2) for randomized trials and the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation methodology.
UNASSIGNED: We included 34 studies with a median sample size of 102 participants. With a moderate certainty of the evidence, the early oral feeding may reduce the time taken for the first passage of the stool (MD -0.99 days; CI 95% -1.25, -0.72), the first flatus (MD -0.70 days; CI 95% -0.87, -0.53), and the risk of complications (RR 0.69; CI 95% 0.59-0.80), while with a low certainty of evidence, it may reduce the length of stay (MD -1.31 days; CI 95% -1.59, -1.03). However, early feeding likely does not affect the risk of vomiting (RR 0.90; CI 95% 0.68, 1.18).
UNASSIGNED: This review suggests that early oral feeding after gastrointestinal surgery may lead to a faster intestinal recovery, shorter postoperative stays, and fewer complications. However, careful interpretation is needed due to high heterogeneity and the moderate-to-low quality of evidence. Future studies should focus on the type and starting time of early oral feeding.