School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
Department of Nutrition and Dietetics, Eastern Health, Box Hill, Victoria, Australia.
Nutr Diet. 2023 Feb;80(1):44-54. doi: 10.1111/1747-0080.12770. Epub 2022 Oct 18.
The aim of this systematic review was to compare the benefits and harms of nasogastric and oral-based refeeding on the quality of care, including effectiveness, safety, and patient experience, for patients hospitalised with an eating disorder.
A systematic search for studies measuring comparative data between nasogastric and oral refeeding methods was conducted in August 2021. Title and abstracts and remaining full texts were screened by both authors. Risk of bias was evaluated using the PEDro scale, and overall quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation narrative synthesis.
Seven studies (one randomised controlled trial, five non-randomised studies of interventions, and one qualitative study) with 917 participants were included. There was low certainty evidence that nasogastric refeeding resulted in no difference or a small increase in weekly weight gain, and moderate certainty of greater total weight gain, and very low certainty of increased length of stay compared to oral refeeding. There was no difference or a small increase in discharge weight and body mass index with nasogastric refeeding compared to oral refeeding. No serious adverse events were reported.
Patients selected for nasogastric refeeding have a longer duration of illness and lower admission weight, making it difficult to determine which refeeding approach is superior. However, the lack of clear difference in weekly weight gain and the lack of reported harms suggests that other factors such as the normalisation of eating behaviour may be taken into account when choosing the most appropriate refeeding method.
本系统评价的目的是比较鼻胃管和口服喂养对住院饮食失调患者的护理质量（包括疗效、安全性和患者体验）的益处和危害。
于 2021 年 8 月对比较鼻胃管和口服喂养方法的研究进行了系统检索。两位作者对标题和摘要以及其余全文进行了筛选。使用 PEDro 量表评估偏倚风险，并使用 Grading of Recommendations, Assessment, Development and Evaluation 叙述性综合评估总体证据质量。
纳入了 7 项研究（1 项随机对照试验、5 项干预措施的非随机研究和 1 项定性研究），共 917 名参与者。有低确定性证据表明，与口服喂养相比，鼻胃管喂养没有或仅有小幅度增加每周体重增加，且有中度确定性证据表明总体重增加更多，而非常低确定性证据表明住院时间延长。与口服喂养相比，鼻胃管喂养在出院体重和体重指数方面没有差异或仅有小幅度增加。没有报告严重不良事件。
选择鼻胃管喂养的患者病程较长，入院时体重较低，难以确定哪种喂养方法更优。然而，每周体重增加没有明显差异，也没有报告危害，这表明在选择最合适的喂养方法时，可能需要考虑其他因素，如进食行为的正常化。
