目的:胃管喂养和幽门后管喂养是危重患者肠内营养的两种常见方式。本研究旨在比较危重病人胃管喂养与幽门后胃管喂养的有效性和安全性。
方法:PubMed,Embase,和CochraneLibrary从开始到2023年3月都系统地搜索了符合条件的试验。使用随机效应模型,使用具有95%置信区间(CI)的相对风险(RR)或加权平均差(WMD)来估计分类和连续结果。
结果:选择涉及1,329名危重患者的16项试验进行最终的荟萃分析。总的来说,我们注意到,胃管喂养与幽门后管喂养在死亡率上没有显着差异(p=0.891),而接受胃管喂养的患者发生肺炎的风险显著增加(RR:1.45;p=0.021).此外,我们注意到胃管饲喂与开始饲喂所需时间较短相关(WMD:-11.05;p=0.007).
结论:这项研究表明,与幽门后管喂养相比,通过胃管开始喂养需要更少的时间。然而,这也与危重患者的肺炎风险增加有关.
OBJECTIVE: Gastric tube feeding and postpyloric tube feeding are two common forms of enteral nutrition in critically ill patients. This study aimed to compare the efficacy and safety of gastric tube feeding with that of postpyloric tube feeding in critically ill patients.
METHODS: PubMed, Embase, and Cochrane Library were systematically searched for eligible trials from their inception until March 2023. Relative risks (RRs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs) were used to estimate categorical and continuous outcomes using the random-effects model.
RESULTS: Sixteen trials involving 1,329 critically ill patients were selected for the final meta-analysis. Overall, we noted that gastric tube feeding showed no significant difference from post-pyloric tube feeding in mortality (p = 0.891), whereas the risk of pneumonia was significantly increased in patients who received gastric tube feeding (RR: 1.45; p = 0.021). Furthermore, we noted that gastric tube feeding was associated with a shorter time required to start feeding (WMD: -11.05; p = 0.007).
CONCLUSIONS: This research revealed that initiating feeding through the gastric tube required less time compared to postpyloric tube feeding. However, it was also associated with a heightened risk of pneumonia among critically ill patients.