摘要
目的系统评价食管胃底静脉曲张出血患者三腔两囊管改良固定方法的临床应用效果。方法计算机检索Cochrane Database of Systematic Review、JBI Database of Systematic Review、Medline(PubMed)、Embase(Ovid)、中国知网、中国生物医学文献数据库、万方数据知识服务平台、维普中文科技期刊数据库中从建库至2016年11月公开发表的以中国患者为对象的三腔两囊管改良固定方法的随机对照实验(randomized controlled trials,RCT)或类实验(controlled clinical trail,CCT),同时检索未公开发表的相关文献和纳入文献的参考文献,由2名研究者按照纳入排除标准严格完成文献质量评价和资料提取,对符合要求的文献采用RevMan 5.3软件和State 12.0软件完成Meta分析。结果共纳入13个CCT,其中12项研究提示改良固定方法不影响有效止血率;7项研究表明改良固定方法更容易为患者接受;5项研究提示改良固定法对减少再出血有显著作用;3项研究表明改良固定方法能够有效地降低气囊破裂的发生率;5项研究提示改良固定方法对减少鼻周黏膜的损伤有显著作用。此外,发表性偏移与敏感性分析结果提示Meta分析结果较为稳定,可信。结论对于食管胃底静脉曲张破裂出血三腔两囊管治疗者,采用改良固定方法可在保证治疗效果的同时,提高患者的接受程度,降低并发症的发生率。
Objective To evaluate the effectiveness of modified immobilization methods on esophagogastric variceal bleeding patients with Sengstaken-Blakemore tube.Methods We searched the Cochrane Database of Systematic Review,JBI Database of Systematic Review,Medline（PubMed）,Embase（Ovid）,CNKI,CBM,WanFang Data and VIP from inception to November 2016 to collect the randomized controlled trials,controlled clinical trial,unpublicized trails and related literature.The quality of literature was critically evaluated,and data was extracted by 2 reviewers independently.Meta-analyses were performed by using RevMan 5.3 and State12.0 software for the eligible literature.Results Thirteen controlled clinical trials were included.Twelve studies proved that modified immobilization methods had no effect on the hemostasis effectiveness rate.Seven studies proved that modified immobilization methods were easier for patients to accept.Five studies prompted that modified immobilization methods could significantly reduce the rate of rebleeding.Three studies indicated that modified immobilization methods significantly reduced the rate of balloon rupture.Five studies proved that modified immobilization methods significantly reduced nasal mucosal injury.Meanwhile,publication bias analysis and sensitivity analysis indicated the robustness of metaanalysis results.Conclusions The modified immobilization methods on esophagogastric variceal bleeding patients with Sengstaken-Blakemore tube are effective in ensuring the treatment outcome and improvingpatient acceptance.Simultaneously,it has a positive effect in reducing complications.
作者
燕芳红
任梓杭
张亚楠
蒋文慧
Yan Fanghong;Ren Zihang;Zhang Yanan;Jiang Wenhui(Department of Nursing,Xi＇an Jiaotong U niversity School of Medicine,Xi＇an 710061,Shanxi Province,China;Department of Cardiology Ⅷ,Tianjin Chest Hospital,Tianjin 300222,China)
出处
《解放军护理杂志》
CSCD
北大核心
2018年第11期1-7,共7页
Nursing Journal of Chinese People's Liberation Army
关键词
三腔两囊管
改良固定方法
有效止血率
患者接受度
并发症
META分析
Seng staken Blakemore tube
modified immobilization methods
rate of effective hemostasis
patient＇s acceptance
complications
Meta analysis
