目的:评价超声监测胃残余量的效果在ICU重症患者肠内营养中的应用价值,为重症患者肠内营养科学实施提供证据.方法:系统检索中国期刊全文数据库(CNKI)、中文科技期刊数据库(VIP)、万方数据知识服务平台、中国生物医学文献数据库(CBM)、PubMed、Embase、Web of Science和Cochrane图书馆从建库至2021年9月15日发表的有关超声监测胃残余量指导ICU重症患者肠内营养治疗的文献.文献检索、文献筛选、资料提取及质量评价由2名研究员分别完成,使用RevMan 5.4软件进行Meta分析.结果:纳入24篇文献,共2 357例患者.与传统注射器回抽法相比,超声监测胃残余量可以降低反流/呕吐发生率(RR=0.43,95％CI=0.34～0.55)、误吸发生率(RR=0.51,95％CI=0.34～0.75)、腹泻发生率(RR=0.61,95％CI=0.49～0.75)、腹胀发生率(RR=0.56,95％CI=0.42～0.74)、ICU 呼吸机相关性肺炎(VAP)发生率(RR=0.49,95％CI=0.35～0.68),缩短患者 ICU 住院时间(MD=-1.71,95％CI=-2.92～-0.50)、提高白蛋白水平(MD=2.45,95％CI=1.35～3.54),合并效应量有统计学意义(P＜0.05).结论:ICU重症患者实施肠内营养过程中利用超声监测胃残余量,可能减少发生各种肠内营养并发症,改善重症患者的营养状况.
Monitoring of stomach residual volume during intestinal nutritional prossess by using bedside ultrasound in ICU patient:a Meta-analysis
Objective:To evaluate the effect of bedside ultrasound in monitoring stomach residual volume,and to provide evidence for enteral nutrition therapy in severely ill patients in ICU.Methods:the Chinese Journal Full-text Database(CNKI),Chinese Sci-tech Journal Full-text Database(VIP)Database,Wanfang Data Knowledge Service Plattorm,Chinese Biomedical Literature Database(CBM),PubMed,Embase,Web of Science and Cochrane Library were systematically searched to collect randomized controlled trails(RCTs)of application of ultrasound to detectstomach residual volume in enteral nutrition of critically ill patients in ICU.The search time limit was from the establishment of the database to September 15,2021.Two researchers independently searched the literature,screened the literature,extracted data,and evaluated the quality of the literature.RevMan 5.4 software was used for Meta-analysis.Results:A total of 24 articles were included,involving 2 358 patients.Compared with the traditional syringe withdrawal method,bedside ultrasound monitoring of gastric residue can reduce the incidence of reflux or vomiting(RR=0.43,95％CI=0.34～0.55),the incidence of aspiration(RR=0.51,95％CI=0.34～0.75),the incidence of bloating or stomach retention(RR=0.52,95％CI=0.41～0.68),and the incidence of ICU ventilator-associated pneumonia(VAP)(RR=0.49,95％CI=0.35～0.68),shorten the length of stay in the ICU(MD=-1.71,95％CI=-2.92～-0.50),increase albumin level(MD=2.45,95％CI=1.35～3.54)and reduce operating time of nurses(MD=-11.96,95％CI=-11.73～-7.20),and the combined effects were statisticallysignificant(P＜0.05).Conclusion:The use of ultrasound to monitor the gastric residual amount of enteral nutrition in severely ill patients in ICU may help reduce the occurrence of various enteral nutrition complications and improve the nutritional status of severely ill patients.
NETL
NSTL
万方数据
维普
