体位干预对管饲饮食患者并发反流与误吸干预效果的Meta分析

Meta-analysis of the effect of postural intervention on tube feeding patients complicated with reflux and aspiration

目的系统评价管饲时床头抬高角度与管饲并发症反流与误吸之间的关系,以期为更好地进行管饲时的体位管理提供证据。方法检索PubMed、Web of Science、Embase、CINAHL Complete护理学全文数据库、中国知网、万方数据库、维普网、中国生物医学文献服务系统数据库,收集不同体位对胃肠内营养支持误吸及反流发生率影响的对照研究,检索时限为建库至2021年11月30日。文献导入EndNote去重后由两名研究者独立筛选文献、提取资料后,使用Revman进行纳入文献Meta分析。结果最终纳入Meta分析文献29篇,2788例患者。与床头抬高<30°相比,≥30°能够明显降低反流、误吸及其他管饲并发症的发生率。结论床头抬高角度≥30°能够预防管饲时误吸、反流、吸入性肺炎、呕吐、呛咳等管饲的发生;左侧卧位能够预防管饲时误吸的发生。

Objective To systematically review the relationship between the angle of bed head elevation during tube feeding and tube feeding complications,reflux and aspiration,in order to provide evidence for better position management during tube feeding.Methods We searched PubMed,Web of Science,Embase,CINAHL Complete Nursing Full-text Database,China National Knowledge Infrastructure,Wanfang Data,VIP,and China Biomedical Literature Service Database,and collected controlled studies on the effects of different body positions on the incidence of aspiration and regurgitation in gastrointestinal nutrition support.,the retrieval time was from the establishment of the database to November 30,2021.After the literature was imported into EndNote,two researchers independently screened the literature,extracted the data,and used Revman to conduct a Meta-analysis of the included literature.Results Twenty-nine articles with 2788 patients were included in the Meta-analysis.Compared with bed head elevation<30°,≥30°can significantly reduce the incidence of regurgitation,aspiration and other tube feeding complications.Conclusion The bed head elevation angle≥30°can prevent the occurrence of aspiration,regurgitation,aspiration pneumonia,vomiting,choking and other tube feeding during tube feeding;the left lateral position can prevent the occurrence of aspiration during tube feeding.