无法手术的恶性肠道阻塞:息干预结果 - 混合方法系统审查
Michael Patterson1, Sarah Greenley2, Yangmyung Ma3
1Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK michael.patterson@hyms.ac.uk.
BMJ supportive & palliative care
|April 1, 2024
概括
父母肠道营养 (PN) 和息通气胃口术 (PVG) 为患者提供了宝贵的家庭时间,并改善了不可手术的恶性肠道阻塞 (MBO) 的生活质量. 然而,关于生存益处的证据仍然不确,需要进一步研究.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 抚慰性护理是一种缓解性护理.
背景情况:
- 恶性肠道阻塞 (MBO) 管理通常涉及肠道营养 (PN) 和息通气胃口 (PVG).
- 有限的数据存在于PN和PVG在不可操作的MBO中的临床和生活质量结果.
- 告知临床决策需要更好地了解这些干预措施的影响.
研究的目的:
- 系统地审查PN和PVG对非手术性MBO患者的临床和生活质量结果的影响.
主要方法:
- 进行了混合方法的系统审查和叙事综合.
- 从创立到2021年4月,搜索了多个数据库 (MEDLINE,Embase,Cochrane,科学网,CINAHL,BASE,HTA,CareSearch) 从创立到2021年4月.
- 包括47项涉及3538名参与者的研究;研究进行了选和质量评估.
主要成果:
- 证据不足以确定PN或PVG是否改善MBO生存率,尽管患者和临床医生相信它们的好处.
- 这两种干预措施似乎让患者在家里有宝贵的时间,PVG可以缓解恶心和吐.
- 通过这两种干预措施改善生活质量,尽管它们会给人带来很大的负担;PN可以维持或改善营养和表现状况.
结论:
- 目前的证据不证实PN或PVG对不可操作的MBO的生存益处.
- 患者和临床医生的信念支持使用这些干预措施,以获得感知的好处.
- 需要精心设计的随机对照试验来最终评估生存结果,解决对平衡的担忧.
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