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穿皮放射性胃口术与穿皮内镜性胃口术用于肠道养:系统性审查和元分析
Matheus Coelho Meine1, Isabela Ho Tusato1, Nathalia Hoffmeister2
1School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Brazil.
JPEN. Journal of parenteral and enteral nutrition
|May 28, 2024
概括
穿皮放射性胃口术 (PRG) 和穿皮内镜性胃口术 (PEG) 在肠道养中具有相似的疗效和安全性. 然而,PEG程序比PRG更快,提供了潜在的优势.
科学领域:
- 胃肠病学 胃肠病学
- 最少侵入性手术的方法
- 手术技巧 手术技巧
背景情况:
- 穿皮放射性胃口术 (PRG) 和穿皮内镜性胃口术 (PEG) 是已确立的长期肠道养的最小侵入性方法.
- 以前的比较研究往往依赖于回顾性数据,导致关于有效性和安全性的不确定的发现.
- 需要来自随机对照试验 (RCT) 的强有力的证据来澄清PRG和PEG的比较性能.
研究的目的:
- 进行对PRG和PEG进行比较的RCT的元分析.
- 评估和比较PRG与PEG的技术成功,安全性 (不良事件和死亡率) 和程序持续时间.
- 提供基于证据的见解,用于临床决策,在肠道食接入.
主要方法:
- 在MEDLINE,Embase和Cochrane图书馆进行了系统的文献搜索,截至2024年2月23日.
- 包括RCT直接比较PRG和PEG用于肠道养.
- 用随机效应模型提取和分析了技术成功,不良事件,死亡率和手术时间的数据.
主要成果:
- 分析了5个RCT,涉及544名患者 (268名PRG,276名PEG).
- 在技术成功 (RR=1.02),整体死亡率 (RR=1.25) 或总体不良事件风险 (RR=1.06) 之间没有发现PRG和PEG之间的显著差异.
- PRG程序的时间比PEG (MD=19.35分钟) 长得多,证据的确定性非常低.
结论:
- 在需要肠道养的患者中,PRG和PEG的疗效和安全性表现相似.
- 穿皮内镜胃口术 (PEG) 提供了一个程序优势,因为它的持续时间比PRG更短.
- 进一步的研究可能是有必要的,以探索患者选择和长期结果的细微差别.
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