回输胃液对重症患者肠内营养喂养不耐受影响的Meta分析

doi:10.3761/j.issn.2096-7446.2026.04.018

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (4): 488-495.doi: 10.3761/j.issn.2096-7446.2026.04.018

回输胃液对重症患者肠内营养喂养不耐受影响的Meta分析

肖乐乐¹(), 肖莉¹^,^*(), 王婧², 谢志芬³, 杨柳², 刘晓兰²

¹ 南方医科大学南方医院赣州医院（赣州市人民医院）护理部赣州市 341000
² 南方医科大学南方医院赣州医院（赣州市人民医院）重症医学科赣州市 341000
³ 南方医科大学南方医院赣州医院（赣州市人民医院）肿瘤科赣州市 341000

收稿日期:2025-04-18 出版日期:2026-04-10 发布日期:2026-04-02
通讯作者: 肖莉 E-mail:330302297@qq.com;rmyyhlb@163.com
作者简介:肖乐乐：女，硕士，主管护师，E-mail：330302297@qq.com
基金资助:
2022年度赣州市指导性科技计划(20222ZDX7717)

Meta-analysis of the impact of gastric juice reinfusion on enteral feeding intolerance in critically ill patients

XIAO Lele¹(), XIAO Li¹^,^*(), WANG Jing², XIE Zhifen³, YANG Liu², LIU Xiaolan²

¹ Nursing Department， Ganzhou Hospital-Nanfang Hospital，Southern Medical University（Ganzhou People’s Hospital）， Ganzhou 341000， China
² Department of Critical Care Medicine， Ganzhou Hospital-Nanfang Hospital，Southern Medical University（Ganzhou People’s Hospital）， Ganzhou 341000， China
³ Oncology Department， Ganzhou Hospital-Nanfang Hospital，Southern Medical University（Ganzhou People’s Hospital）， Ganzhou 341000， China

Received:2025-04-18 Online:2026-04-10 Published:2026-04-02
Contact: XIAO Li E-mail:330302297@qq.com;rmyyhlb@163.com
Supported by:
Guiding Science and Technology Program of Ganzhou City in 2022(20222ZDX7717)

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摘要/Abstract

摘要：

目的系统评价回输胃液对重症患者肠内营养喂养不耐受的影响。方法系统检索PubMed、Web of Science、Cochrane Library、Ovid、CINAHL、Embase、中国生物医学文献数据库、中国知网、万方数据库、维普数据库中关于重症患者肠内营养回输胃液的随机对照试验，检索时限为建库至2025年1月26日。由2名研究员独立进行文献筛选、资料提取和质量评价，采用RevMan 5.4软件进行Meta分析。结果最终纳入8项随机对照试验，共574例患者。Meta分析显示，回输胃液在降低患者恶心/呕吐[RR=0.44，95%CI（0.21，0.95），P=0.036]、腹胀[RR=0.49，95%CI（0.31， 0.79），P=0.003]、便秘[RR=0.22，95%CI（0.05，0.99），P=0.048]的发生率上优于弃去胃液组，差异具有统计学意义。在胃残余量[MD=-9.55，95%CI（-21.83，2.73），P=0.127]、胃排空延迟发生率[RR=1.09，95%CI（0.72，1.65），P=0.692]、腹泻发生率[RR=0.60，95%CI（0.33，1.11），P=0.102]、血清白蛋白[SMD=0.18，95%CI（-0.13，0.49），P=0.248]、血浆总蛋白[SMD=0.18，95%CI（-0.13，0.50），P=0.245]和低血钾症发生率[RR=0.75，95%CI（0.47，1.18），P=0.213]方面的差异均无统计学意义。在血红蛋白[SMD=0.41，95%CI（-0.04，0.87），P=0.077]、电解质紊乱发生率[RR=0.56，95%CI（0.29，1.08），P=0.085]方面的差异接近统计学显著性。结论回输胃液在降低重症患者恶心/呕吐、腹胀及便秘的发生率方面具有优势，而在改善胃残余量、胃排空延迟、腹泻、营养学及电解质水平方面的效果不显著，需更多高质量随机对照试验进一步验证。在临床护理实践中，建议根据重症患者胃潴留的具体程度，循序渐进地实施胃液回输策略，以改善患者的胃肠道症状。

关键词: 重症患者, 肠内营养, 回输胃液, 喂养不耐受, Meta分析

Abstract:

Objective To systematically evaluate the impact of gastric juice reinfusion on enteral feeding intolerance in critically ill patients. Methods A systematic search was conducted in PubMed，Web of Science，Cochrane Library，Ovid，CINAHL，Embase，China National Knowledge Infrastructure，Wanfang Data，and VIP Database for randomized controlled trials（RCTs） regarding the reinfusion of gastric juice in critically ill patients receiving enteral nutrition. The search time period was from the establishment of the database to January 2025. Two researchers independently performed literature screening，data extraction，and quality assessment，with RevMan 5.4 software used for meta-analysis. Results A total of eight RCTs involving 574 patients were ultimately included. Meta-analysis indicated that reinfusion of gastric juice was superior to its disposal in reducing the incidence of nausea/vomiting[RR=0.44，95%CI（0.21，0.95），P=0.036]，abdominal bloating[RR=0.49，95%CI（0.31，0.79），P=0.003]，and constipation[RR=0.22，95%CI（0.05，0.99），P=0.048]，with statistically significant differences. However，there were no significant differences in gastric residual volume[MD=-9.55，95%CI（-21.83，2.73），P=0.127]，the incidence of gastric emptying delay[RR=1.09，95%CI（0.72，1.65），P=0.692]，diarrhea[RR=0.60，95%CI（0.33，1.11），P=0.102]，serum albumin（SMD=0.18，95%CI[-0.13，0.49]，P=0.248），plasma total protein（SMD=0.18，95%CI[-0.13，0.50]，P=0.245），or the incidence of hypokalemia（RR=0.75，95%CI[0.47，1.18]，P=0.213）. Differences in hemoglobin（SMD=0.41，95%CI[-0.04，0.87]，P=0.077） and the incidence of electrolyte disturbances（RR=0.56，95%CI[0.29，1.08]，P=0.085） were close to statistical significance. Conclusion Reinfusion of gastric juice is significantly advantageous in reducing the incidence of nausea/vomiting，abdominal bloating，and constipation，while its effects on improving gastric residual volume，gastric emptying delay，diarrhea，nutritional status，and electrolyte levels are not significant. Further validation with more high-quality RCTs is warranted. In clinical nursing practice，it is recommended to implement gastric juice reinfusion strategies gradually based on the specific degree of gastric retention in critically ill patients to improve gastrointestinal symptoms.

Key words: Critically Ill Patients, Enteral Nutrition, Gastric Juice Reinfusion, Feeding Intolerance, Meta-Analysis

肖乐乐, 肖莉, 王婧, 谢志芬, 杨柳, 刘晓兰. 回输胃液对重症患者肠内营养喂养不耐受影响的Meta分析[J]. 中华急危重症护理杂志, 2026, 7(4): 488-495.

XIAO Lele, XIAO Li, WANG Jing, XIE Zhifen, YANG Liu, LIU Xiaolan. Meta-analysis of the impact of gastric juice reinfusion on enteral feeding intolerance in critically ill patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(4): 488-495.

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回输胃液对重症患者肠内营养喂养不耐受影响的Meta分析

Meta-analysis of the impact of gastric juice reinfusion on enteral feeding intolerance in critically ill patients

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