【摘要】 目的探讨长期鼻饲患者硅胶胃管更换的最佳时间间隔。方法全面检索国内外相关文献,采用Cochrane系统评价方法对符合纳入、排除标准的随机对照试验进行Meta分析,研究对象为已发表的有关长期鼻饲患者硅胶胃管更换时间间隔的临床研究文献,观察指标分为两个方面:一为长期鼻饲患者硅胶胃管不同更换频率下的患者鼻粘膜受损情况(充血、水肿及糜烂);二为长期鼻饲患者硅胶胃管不同更换频率下硅胶胃管前端5～12 cm的颜色改变。干预有效性的效应量采用相对危险度(relative risk,RR)。结果共检索到9篇合格文献。Meta分析结果为:长期鼻饲患者硅胶胃管每1周更换1次与每4周更换1次鼻粘膜受损的RR值为1.54[95%CI(0.82,2.88),P=0.02]、硅胶胃管前端5～12 cm颜色改变的RR值为0.14[95%CI(0.01,2.62),P=0.19]。结论长期鼻饲患者硅胶胃管每1周更换1次与每4周更换1次者,硅胶胃管前端5～12 cm颜色改变无统计学意义,每周更换鼻饲胃管的患者鼻粘膜受损的相对危险度是每4周更换的1.54倍,且有统计学意义。综合临床最优原则、硅胶胃管的材料性质及Meta分析结果,得出硅胶胃管4周更换1次为宜。更多还原

【Abstract】 Objective: To investigate the best time interval for silicone stomach tube replacement of the long-term nasal feeding patients. Methods: Based on the analysis of the research results reported, we used the Cochrane system evaluation method to make meta-analysis of the randomized controlled trial with the inclusive criteria and exclusion criteria. The objective was long-term nasal feeding patients with silicone stomach tube replacement. We observed the nasal mucosa damage(congestion, edema and erosion) and the front of silicone stomach tube color of the patients with silicone stomach tube under different replacement frequency. And the relative risk(RR) was used for the effect quantity of intervention effectiveness.Results: A total of 9 references were selected. Meta-analysis results showed that the nasal mucosa damage and color change RR value of silicone stomach tube at 1 and 4 weeks were 1.54[95%CI(0.82, 2.88), P=0.02] and 0.14[95%CI(0.01, 2.62), P=0.19], respectively. Conclusion: There is no significant difference in the nasal mucosa damage and the color changes at the 5～12 cm of the silicone gastric tube in patients. While the relative risk of nasal mucosa damage of patients with weekly nasogastric feeding gastric tube replacement is 1.54 times compared with the nasogastric feeding gastric tube replacement at 4 weeks. Based on the principle of optimization clinical resources, the material properties of silicone gastric tubes and the data of meta-analysis, it is appropriate to replace the silicone gastric tubes every 4 weeks.更多还原