Faculty of Education and Health, University of Greenwich, London SE9 2UG, UK.
Rockfield Medical Devices, Galway H91 DCH9, Ireland.
Nutrients. 2019 May 10;11(5):1046. doi: 10.3390/nu11051046.
Patients with functional gastrointestinal tract who are unable to meet their nutritional requirements may benefit from the use of enteral nutrition via feeding tubes which could be nasogastric, percutaneous endoscopic gastrostomy and jejunostomy. Although enteral tube feeding has been shown to promote nutritional status, improve wound healing, and enhance patients' quality of life (QoL), evidence of tube and feed complications and reduced QoL has also been reported. Despite the increasing prevalence of patients on enteral tube feeding, no systematic review examining the role of enteral tube feeding on patients' QoL appears to have been published.
The aim of this systematic review is to evaluate the effect of enteral tube feeding on patients' QoL.
Three databases (EMBASE, Pubmed, and PsycINFO) plus Google Scholar were searched for relevant articles based on the Population, Intervention, Comparator, Outcomes (PICO) framework. The review was in line with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and involved the use of synonyms and medical subject headings. In addition, search terms were combined using Boolean operators (AND/OR) and all the articles retrieved were exported to EndNote for de-duplication.
Fourteen articles which met the criteria were included and three distinct areas were identified: the effect of early versus late enteral tube feeding on QoL; the QoL of patients on gastrostomy versus standard care, and the effect of enteral tube feeding on QoL. Overall, nine studies reported improvement in the QoL of patients on enteral tube feeding, while five studies demonstrated either no significant difference or reduction in QoL. Some factors which may have influenced these outcomes are differences in types of gastrostomy tubes, enteral feeding methods (including time patients spent connected to enteral feed/pump), and patients' medical conditions, as well as the generic and/or type of QoL measuring instrument used.
Most reviewed studies suggest that enteral tube feeding is effective in improving patients' QoL. The use of enteral tube feeding-specific QoL measuring instruments is recommended for future research, and improved management strategies including use of mobile enteral feeding pumps should further enhance patients' QoL. More studies on the effect of delivery systems/enteral feeding pumps on QoL are needed as research in this area is limited.
本系统评价旨在评估肠内管饲对患者生活质量（QoL）的影响。
根据人群、干预、比较、结局（PICO）框架，在 EMBASE、Pubmed 和 PsycINFO 这三个数据库以及 Google Scholar 上搜索相关文章。本综述符合系统评价和荟萃分析的首选报告项目（PRISMA）指南，并使用同义词和医学主题词进行了检索。此外，使用布尔运算符（AND/OR）组合了检索词，并将检索到的所有文章都导出到 EndNote 进行去重。
共纳入 14 篇符合标准的文章，确定了三个不同的领域：早期与晚期肠内管饲对 QoL 的影响；胃造口术患者与标准护理的 QoL 比较；以及肠内管饲对 QoL 的影响。总体而言，9 项研究报告肠内管饲患者的 QoL 得到改善，而 5 项研究表明 QoL 无显著差异或降低。影响这些结果的一些因素包括胃造口管的类型、肠内喂养方法（包括患者连接肠内喂养/泵的时间）以及患者的医疗状况，以及使用的通用和/或特定类型的 QoL 测量仪器。
大多数回顾性研究表明肠内管饲能有效改善患者的 QoL。建议未来的研究使用肠内管饲特定的 QoL 测量仪器，并采用改良的管理策略，包括使用移动肠内喂养泵，以进一步提高患者的 QoL。由于该领域的研究有限，需要更多关于输送系统/肠内喂养泵对 QoL 影响的研究。
Zotero 插件