摘要:
Objective To assess on the effect of the different catheterization on patients with oral poisoning gastric lavage systematically and objectively. Methods A computerized search of PubMed, the Cochrane Library, EMBASE, Springer Link, Science Direct,China Biology Medicine (CBM),China National Knowledge Internet(CNKI), Wanfang Data and VIP database was performed for relevant randomized controlled trials (RCTs) which investigated the effects of the oral intubation gastric lavage on patients with oral poisoning relative to nasogastric lavage, retrieval to January 2016, and back into the study of references. According to include and exclude standard to screening literature, literature which met inclusion criteria was selected for quality evaluation and data extraction. Meta-analysis and trial sequential analysis were performed by using Rev-Man 5.3 and TSA soft-ware to estimate the required information size (RIS). Results 13 studies incorporated into Meta-analysis including a total o 1 296 patients. Meta-analysis results showed that the oral intubation gastric lavage group was better than nasogastric lavage in shortening the time of intubation [MD=-9.05, 95% CI(-12.86--5.23), P=0.00], improving the rate of intubation for the first time [MD=1.36, 95% CI (1.14-1.62), P =0.00], mucosal bleeding complication [MD=0.11, 95% CI (0.04-0.64), P=0.010], nausea and vomiting [MD=0.60, 95%CI (0.37-0.98), P=0.04], kinking [MD=0.14, 95% CI (0.02-0.80), P=0.03], reflex cardiac arrest [MD=0.24, 95% CI (0.08-0.71), P=0.01] and asphyxia [MD=0.45, 95% CI (0.26-0.80), P=0.007], the difference were statistically significant. But no significant difference existed in gastric tube fall off. Conclusions The oral intubation gastric lavage could shorten intubation time of patients, improve the first time intubation rate and reduce certain complications. It suggests that the oral intubation be extensively applied to care patients with oral poisoning.%目的:系统评价不同途径置管洗胃对口服中毒患者效果的影响。方法计算机检索PubMed、Cochrane Library、EMBASE、Springer Link、Science Direct和中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、万方数字化期刊全文数据库(Wanfang Data)和维普数据库(VIP)中有关不同途径置管洗胃对口服中毒患者研究的随机对照试验(RCT),检索日期截至2016年1月,并追溯纳入研究的参考文献。按照纳入和排除标准筛选文献、对符合纳入标准的研究进行质量评价,并从中提取数据。采用Review Manager 5.3软件进行Meta分析,试验序贯分析估算各结局指标期望信息量。结果共纳入13个研究,合计1296例患者。Meta分析结果显示,经口腔置管组在缩短置管时间[MD=-9.05,95%CI(-12.86~-5.23),P=0.00]、首次置管成功率[MD=1.36,95%CI (1.14~1.62),P=0.00]、置管并发症黏膜出血[MD=0.11,95%CI(0.04~0.64),P=0.010]、恶心呕吐[MD=0.60,95%CI(0.37~0.98),P=0.04]、胃管盘曲口腔[MD=0.14,95%CI(0.02~0.80),P=0.03]、反射性心跳骤停[MD=0.24,95%CI(0.08~0.71),P=0.01]和窒息[MD=0.45,95%CI(0.26~0.80),P=0.007]方面均明显优于经鼻腔置管,差异均有统计学意义(P<0.05)。但在胃管脱出并发症方面差异无统计学意义(P>0.05)。结论经口腔置管洗胃可缩短患者的置管时间,提高首次置管成功率及减少部分并发症,建议临床推广使用。