口服和肠内管饲精氨酸补充在压疮护理中的应用:系统评价和荟萃分析。
The use of oral and enteral tube-fed arginine supplementation in pressure injury care: A systematic review and meta-analysis.
机构信息
School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Pediatric, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Nurs Open. 2022 Nov;9(6):2552-2561. doi: 10.1002/nop2.974. Epub 2021 Jun 25.
AIM
Pressure injuries (PIs) are one of the most common complications related to immobility, especially in hospitalized patients, which lead to increased morbidity, infection and overall decreased quality of life. Arginine supplementation may prevent the development of PIs. This study has summarized the findings of studies on the effect of arginine supplementation on PI healing.
DESIGN
Systematic review and meta-analysis.
METHODS
This study was conducted on online electronic databases including PubMed, Scopus, Web of Science, Google Scholar and Embase to identify relevant clinical trial studies up to September 2020. The pooled effect size of arginine supplement effects on PI was evaluated with standard mean difference (SMD) with 95% confidence interval (CI).
RESULTS
Eight studies met the inclusion criteria for this meta-analysis with 196 patients. PIs were significantly improved with Arginine supplementation (SMD: -0.6; CI 95%: -0.9 to -0.3, I : 72.5%, p = .001). Subgroup analysis showed that administering Arginine supplement more than 15 g/day had more beneficial effects on the healing of PIs (SMD: -2.8; CI 95%: -4.08 to -1.52, I : 54.7%, p = .138).
CONCLUSIONS
Our findings suggest that the administration of Arginine supplement in patients with PIs can accelerate the healing of this type of ulcer. Arginine is a supplement, and primary treatment is still needed to optimize PI healing. Therefore, arginine supplementation in addition to primary treatment seems to be an appropriate approach for the healing of PIs. Further well-designed studies are necessary to prevent the development of PIs compared to their primary treatment.
目的
压力性损伤(PI)是与卧床相关的最常见并发症之一,尤其是在住院患者中,这会导致发病率增加、感染和整体生活质量下降。精氨酸补充可能预防 PI 的发生。本研究总结了精氨酸补充对 PI 愈合影响的研究结果。
设计
系统评价和荟萃分析。
方法
本研究在在线电子数据库中进行,包括 PubMed、Scopus、Web of Science、Google Scholar 和 Embase,以确定截至 2020 年 9 月的相关临床试验研究。使用标准均数差(SMD)和 95%置信区间(CI)评估精氨酸补充对 PI 的影响的汇总效应量。
结果
8 项研究符合本荟萃分析的纳入标准,共纳入 196 名患者。精氨酸补充可显著改善 PI(SMD:-0.6;CI 95%:-0.9 至-0.3,I²:72.5%,p=0.001)。亚组分析表明,每天补充精氨酸超过 15g 对 PI 的愈合有更有益的效果(SMD:-2.8;CI 95%:-4.08 至-1.52,I²:54.7%,p=0.138)。
结论
我们的研究结果表明,PI 患者给予精氨酸补充可以加速这种溃疡的愈合。精氨酸是一种补充剂,仍需要主要治疗来优化 PI 的愈合。因此,精氨酸补充除了主要治疗外,似乎是 PI 愈合的一种合适方法。与主要治疗相比,还需要进一步设计良好的研究来预防 PI 的发生。