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囊性纤维化的肠内管饲法

Enteral tube feeding for cystic fibrosis.

作者信息

Conway Steven, Morton Alison, Wolfe Susan

机构信息

Regional Adult Cystic Fibrosis Unit, St James’Hospital, Leeds,UK.

出版信息

Cochrane Database Syst Rev. 2012 Dec 12;12:CD001198. doi: 10.1002/14651858.CD001198.pub3.

Abstract

BACKGROUND

Enteral tube feeding is routinely used in many cystic fibrosis centres when oral dietary and supplement intake has failed to achieve an adequate nutritional status. The use of this method of feeding is assessed on an individual basis taking into consideration the patients age and clinical status.

OBJECTIVES

To examine the evidence that in people with cystic fibrosis, supplemental enteral tube feeding improves nutritional status, respiratory function, and quality of life without significant adverse effects.

SEARCH METHODS

We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We also contacted the companies that market enteral feeds and reviewed their databases.Date of the most recent search of the Group's Cystic Fibrosis Trials Register: 03 September 2012.Date of the most recent hand search of PubMed and conference abstract books: 15 June 2012.

SELECTION CRITERIA

All randomised controlled trials comparing supplemental enteral tube feeding for one month or longer with no specific intervention in people with cystic fibrosis.

DATA COLLECTION AND ANALYSIS

Thirty-one trials were identified by the searches; however, none were eligible for inclusion in this review.

MAIN RESULTS

There are no trials included in this review.

AUTHORS' CONCLUSIONS: Supplemental enteral tube feeding is widely used throughout the world to improve nutritional status in people with cystic fibrosis. The methods mostly used, nasogastric or gastrostomy feeding, are expensive and may have a negative effect on self-esteem and body image. Reported use of enteral tube feeding suggests that it results in nutritional and respiratory improvement; but, efficacy has not been fully assessed by randomised controlled trials. It is acknowledged, however, that performing a randomised controlled trial would be difficult due to the ethics of withholding an intervention in a group of patients whose nutritional status necessitates it.

摘要

背景

当经口饮食和补充剂摄入未能达到足够的营养状态时,肠内管饲法在许多囊性纤维化治疗中心被常规使用。这种喂养方法的使用会根据患者的年龄和临床状况进行个体化评估。

目的

研究补充性肠内管饲法能改善囊性纤维化患者的营养状况、呼吸功能和生活质量且无显著不良反应的证据。

检索方法

我们检索了Cochrane囊性纤维化和遗传疾病组试验注册库,该注册库包含从全面的电子数据库检索以及对相关期刊和会议论文摘要书籍的手工检索中识别出的参考文献。我们还联系了销售肠内营养制剂的公司并查阅了他们的数据库。该组囊性纤维化试验注册库的最新检索日期:2012年9月3日。PubMed和会议摘要书籍的最新手工检索日期:2012年6月15日。

选择标准

所有比较补充性肠内管饲法一个月或更长时间与对囊性纤维化患者不进行特定干预的随机对照试验。

数据收集与分析

检索共识别出31项试验;然而,没有一项符合纳入本综述的条件。

主要结果

本综述未纳入任何试验。

作者结论

补充性肠内管饲法在全球被广泛用于改善囊性纤维化患者的营养状况。最常用的方法,即鼻胃管喂养或胃造口术喂养,费用高昂,可能对自尊和身体形象产生负面影响。报告的肠内管饲法使用情况表明其能改善营养和呼吸状况;但是,随机对照试验尚未充分评估其疗效。然而,由于对一组营养状况需要干预的患者不进行干预存在伦理问题,进行随机对照试验会很困难。

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