无负压引流胃肠减压对胃癌根治术后病人胃肠功能影响的系统评价
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摘要
[目的]系统评价无负压引流胃肠减压对胃癌根治术后病人胃肠功能的影响。[方法]检索PubMed、EMbase、CENTRAL、CINAHL、AMED、中国知网、中国生物医学文献数据库、维普和万方数据库有关胃癌根治术后病人应用无负压引流胃肠减压的随机对照试验,采用Cochrane偏倚风险评价工具对纳入研究进行质量评价。[结果]纳入10项研究,888例病人。Meta分析结果显示:与负压引流胃肠减压相比,无负压引流胃肠减压可降低胃癌根治术后病人的肠鸣音恢复时间[MD=-10.67,95%CI(-12.28,-9.06),P<0.05]、肛门首次排气时间[MD=-1.01,95%CI(-1.38,-0.64),P<0.05]、胃管留置时间[MD=-1.53,95%CI(-1.70,-1.36),P<0.05]。[结论]无负压引流胃肠减压可缩短胃癌根治术后病人的肠鸣音恢复时间、肛门首次排气时间、胃管留置时间。受纳入研究质量的限制,研究结论尚需更多高质量研究进一步验证。
Objective:To systematically evaluate effect of no negative pressure drainage gastrointestinal decompression on gastrointestinal function in patients after radical gastrectomy.Methods:Randomized controlled trials on the application of non-negative pressure drainage for gastrointestinal decompression in patients after radical gastrectomy were searched in PubMed,EMbase,CENTRAL,CINAHL,AMED,CNKI,CBM,Wanfang and VIP database.The Cochrane bias risk assessment tool was used to evaluate the quality of studies.Results:A total of 10 studies,with 888 patients were included.Meta analysis showed that compared with the negative pressure drainage of gastrointestinal decompression,no negative pressure drainage of gastrointestinal decompression could reduce the recuperation time for bowel sounds[MD=-10.67,95%CI(-12.28,-9.06),P<0.05),initial anal exhaust time[MD=-1.01,95%CI(-1.38,-0.64),P<0.05),gastric tube retention time[MD=-1.53,95%CI(-1.70,-1.36),P<0.05].Conclusions:No negative pressure drainage gastrointestinal decompression could shorten the recuperation time for bowel sounds,initial anal exhaust time and gastric tube retention time of patients after radical gastrectomy.Limited by the quality of the included studies,more high-quality studies are needed to verify the conclusions.
Objective:To systematically evaluate effect of no negative pressure drainage gastrointestinal decompression on gastrointestinal function in patients after radical gastrectomy.Methods:Randomized controlled trials on the application of non-negative pressure drainage for gastrointestinal decompression in patients after radical gastrectomy were searched in PubMed,EMbase,CENTRAL,CINAHL,AMED,CNKI,CBM,Wanfang and VIP database.The Cochrane bias risk assessment tool was used to evaluate the quality of studies.Results:A total of 10 studies,with 888 patients were included.Meta analysis showed that compared with the negative pressure drainage of gastrointestinal decompression,no negative pressure drainage of gastrointestinal decompression could reduce the recuperation time for bowel sounds[MD=-10.67,95%CI(-12.28,-9.06),P<0.05),initial anal exhaust time[MD=-1.01,95%CI(-1.38,-0.64),P<0.05),gastric tube retention time[MD=-1.53,95%CI(-1.70,-1.36),P<0.05].Conclusions:No negative pressure drainage gastrointestinal decompression could shorten the recuperation time for bowel sounds,initial anal exhaust time and gastric tube retention time of patients after radical gastrectomy.Limited by the quality of the included studies,more high-quality studies are needed to verify the conclusions.
引文
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[14]郭锐.不同胃肠减压方式对胃癌根治术后患者胃肠功能恢复的影响[J].山西医药杂志,2016,45(7):831-833.
[15]封亦兵.不同胃肠减压方式对胃癌根治术后患者胃肠功能恢复的影响比较[J].中国基层医药,2016,23(15):2380-2383.
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[19]CARR R E N,SEULIN P,JULIO C H,et al.Is nasogastric or nasojejunal decompression necessary after gastrectomy:aprospective randomized trial[J].World Journal of Surgery,2007,31(1):122-127.
[20]王臻.聚乙二醇电解质溶液对腹部手术后胃肠功能恢复的影响[J].医药前沿,2015(18):357.
[21]谢旭峰.腹部手术后补钾对胃肠功能恢复的影响[J].中华现代外科学杂志,2011,9(28):276-277.
[22]王建忠,江志伟,鲍扬,等.胃肠道手术中不常规留置胃肠减压管并早期进食的临床应用研究[J].中国实用外科杂志,2009,12(4):331-332.
[23]任智,畅任伟.腹部手术后无需常规胃肠减压[J].山西医科大学学报,1991(2):124-127.
[24]CLEVERS G J,SMOUT A J.The natural course of postoperative ileus following abdominal surgery[J].Netherlands Journal of Surgery,1989,41(5):97-99.
[25]GERBER A.An appraisal of paralytic ileus and the necessity for postoperative gastrointestinal suction[J].Surgery Gynecology&Obstetrics,1963,117(2):294-297.
[26]高国栋.腹部手术切口感染相关危险因素研究[J].中华医院感染学杂志,2013,23(2):97-99.
[27]张小红,罗丽霞.腹部手术切口感染危险因素调查分析及预防[J].中南医学科学杂志,2010,38(2):301-302.
[2]MANNING B J,WINTER D C,MCGREAL G,et al.Nasogastric intubation causes gastroesophageal reflux in patients undergoing elective laparotomy[J].Surgery,2001,130(5):788-791.
[3]NELON R,EDWARDS S,TSE B.Prophylactic nasogastric decompression after abdominal surgery[J].The Cochrane Database of Systematic Reviews,2007,3(3):CD004929.
[4]NELSON R,TSE B,EDWARDS S.Systematic review of prophylactic nasogastric decompression after abdominal operations[J].British Journal of Surgery,2005,92(6):673.
[5]PEARL M L,VALEA F A,FISCHER M,et al.A randomized controlled trial of postoperative nasogastric tube decompression in gynecologic oncology patients undergoing intra-abdominal surgery[J].Obstetrics&Gynecology,1996,88(3):399-402.
[6]王会英,王燕,邓艳,等.不同胃肠减压方式对胃癌根治术后患者胃肠功能恢复的影响[J].中华护理杂志,2010,45(11):1012-1013.
[7]WANG Y,WANG H,WANG C.Effect of vacuum dealed drainage on recovery of gastrointestinal function in gastric cancer patients after radical gastrectomy[J].Cancer Biology and Medicine,2012,9(4):266-269.
[8]黄丽萍,李静.胃癌根治术后不同胃肠减压方式对患者胃肠功能恢复的影响[J].安徽医药,2014(8):1535-1537.
[9]李茂林.不同胃肠减压方式对胃癌根治术后患者功能恢复的影响[J].微创医学,2015,10(6):836-837.
[10]孙威海.不同胃肠减压方式对胃癌根治术后患者功能恢复的影响[J].实用癌症杂志,2015,30(5):747-749.
[11]王本锋,邵俊伟.不同胃肠减压方式下胃癌根治术后患者胃液引流情况及胃肠功能恢复情况分析[J].中国公共卫生,2015(A03):23-24.
[12]李智永.胃癌术后无负压自然引流胃肠减压对胃肠功能恢复的影响[J].中国卫生标准管理,2016(2):12-13.
[13]刘晓平,刘慷,蒋辉,等.自然引流胃肠减压对胃癌根治术后患者胃肠功能的影响[J].西部医学,2016,28(9):1264-1266.
[14]郭锐.不同胃肠减压方式对胃癌根治术后患者胃肠功能恢复的影响[J].山西医药杂志,2016,45(7):831-833.
[15]封亦兵.不同胃肠减压方式对胃癌根治术后患者胃肠功能恢复的影响比较[J].中国基层医药,2016,23(15):2380-2383.
[16]袁万顺,李维芝.肠道手术后停用胃管的研究(附400例报告)[J].中国肛肠病杂志,2001(10):11-12.
[17]王燕.不同胃肠减压方式对胃癌根治术后患者功能恢复的影响[D].天津:天津医科大学,2013.
[18]DOGLIETTO G B,PAPA V,TORTORELLI A P,et al.Nasojejunal tube placement after total gastrectomy:a multicenter prospective randomized trial[J].Archives of Surgery,2004,139(12):1313-1320.
[19]CARR R E N,SEULIN P,JULIO C H,et al.Is nasogastric or nasojejunal decompression necessary after gastrectomy:aprospective randomized trial[J].World Journal of Surgery,2007,31(1):122-127.
[20]王臻.聚乙二醇电解质溶液对腹部手术后胃肠功能恢复的影响[J].医药前沿,2015(18):357.
[21]谢旭峰.腹部手术后补钾对胃肠功能恢复的影响[J].中华现代外科学杂志,2011,9(28):276-277.
[22]王建忠,江志伟,鲍扬,等.胃肠道手术中不常规留置胃肠减压管并早期进食的临床应用研究[J].中国实用外科杂志,2009,12(4):331-332.
[23]任智,畅任伟.腹部手术后无需常规胃肠减压[J].山西医科大学学报,1991(2):124-127.
[24]CLEVERS G J,SMOUT A J.The natural course of postoperative ileus following abdominal surgery[J].Netherlands Journal of Surgery,1989,41(5):97-99.
[25]GERBER A.An appraisal of paralytic ileus and the necessity for postoperative gastrointestinal suction[J].Surgery Gynecology&Obstetrics,1963,117(2):294-297.
[26]高国栋.腹部手术切口感染相关危险因素研究[J].中华医院感染学杂志,2013,23(2):97-99.
[27]张小红,罗丽霞.腹部手术切口感染危险因素调查分析及预防[J].中南医学科学杂志,2010,38(2):301-302.