间歇经口管饲法对脑卒中吞咽障碍患者影响的Meta分析

Effects of intermittence tube feeding on the swallowing function and nutrition status of stroke patients with dysphagia:a Meta-analysis

目的通过Meta分析探讨间歇经口管饲法对脑卒中吞咽障碍患者吞咽功能的影响。方法计算机检索英文数据库(PubMed、OVID、Embase和Web of science)和中文数据库(万方和知网),检索时限为2010-01—2018-05,统计学软件采用5.3版RevMan。结果根据纳入和排除标准,共纳入13篇文献,Meta分析显示,(1)间歇经口管饲法可改善脑卒中吞咽障碍患者的吞咽功能(n=679;RR=1.33;95%CI1.23~1.44),采用洼田饮水试验评估时,可降低吞咽功能评分(n=189;MD=-0.19;95%CI-0.29^-0.08);(2)间歇经口管饲法可提高护士置管成功率(n=177;RR=1.56;95%CI1.28~1.89);(3)间歇经口管饲法可提高患者血清前白蛋白(n=276;MD=1.74;95%CI1.24~2.24)和血清白蛋白(n=276;MD=17.02;95%CI8.93~25.10)。结论基于当前的证据,间歇经口管饲法能提高脑卒中吞咽障碍患者的吞咽功能和改善营养指标。

Objective To evaluate the effectiveness of intermittence tube feeding on the swallowing function and nutrition status of stroke patients with dysphagia.Methods PubMed,EMBASE,OVID,Web of science,CNKI and Wanfang Data were searched from January 2010 to May 2018.Randomized controlled trials of intermittence tube feeding against nasogastric tube were identified.Two assessors independently reviewed each trial.The Cochrane risk of bias assessment tool was used for quality assessment.Results 13 trials involving 930 patients fed via nasogastric tube and intermittence tube feeding were identified.Compared with nasogastric tube,Intermittence tube feeding showed significant effects in increasing dysphagia function(n=679;RR=1.33;95%CI1.23-1.44);Intermittence tube feeding can enhance nurse’s successful rate of intubation compared with nasogartric tube(n=177;RR=1.56;95%CI1.28-1.89).Conclusion Based on current evidence,intermittence tube feeding can improve swallowing function and improve nutritional indexes in patients with stroke and swallowing disorders.