Keywords
Length of gastric tube
Modified gastric tube
Meta-analysis
Systematic evaluation
Complications
Submitted : 2024-09-29
Accepted : 2024-10-14
Published : 2024-10-29
Abstract
Objective: To systematically evaluate the effect of modified length of gastric tube implantation in stroke patients. Methods: Randomized controlled studies on the effect of narrative therapy on negative emotions of malignant tumor patients were published in PubMed, EMbase, Web of Science, Cochrane Library, CNKY. Wanfang Data, VIP Database and CBM disc from database establishment to May 2021. RewMan 5.2 software was used for the meta-analysis. Results: Ten articles were included, involving 1140 patients in total. Results of meta-analysis showed that improved length of gastric tube implantation could reduce the incidence of aspiration pneumonia in stroke patients with enteral nutrition [OR = 0.18, 95% CI (0.10, 0.31), P < 0.00001], reduce gastroesophageal reflux rate (OR = 0.13, 95% CI (0.04, 0.38), P < 0.0002], the incidence of aspiration (OR = 0.23, 95% CI (0.11, 0.38), P < 0.00001], the incidence of abdominal distension and diarrhea (OR = 0.13, 95% CI (0.06, 0.28), P < 0.00001], the incidence of choking cough (OR = 0.20, 95% CI (0.07, 0.61), P < 0.005], but no difference between the two groups in terms of reducing gastric residual (OR = 0.10, 95% CI (2.40, 2.60), P = 0.94]. Conclusions: The modified length of the gastric tube can replace the traditional length of the gastric tube in the application of stroke patients, can reduce the complications of enteral nutrition, is safe and feasible. However, due to the limitation of the quality and quantity of the included studies, we should be cautious about the results of this meta-analysis and expect to carry out more large-sample and high-quality randomized controlled trials for demonstration.
References
Wang L, Liu J, Yang Y, et al., 2019, China Still Faces Huge Challenges in the Prevention and Treatment of Stroke: A Summary of the “China Stroke Prevention and Treatment Report 2018.” Chinese Circulation Journal, 34(2): 105–119.
Guo B, 2020, The Impact of Different Gastric Tube Indwelling Lengths on Stroke Patients with Swallowing Disorders. Nursing Practice and Research, 17: 139–141.
Su Y, Pan S, Peng B, et al., 2019, Chinese Expert Consensus on Enteral Nutrition Support for Neurological Diseases (Second Edition). Chinese Journal of Clinical Nutrition, 27(4): 193–203.
Chen L, Chen Y, Yu A, et al., 2021, Current Status and Influencing Factors of Feeding Intolerance in Critically Ill Patients with Neurological Diseases Receiving Enteral Nutrition. Nursing Research, 35(7): 1285–1289.
Sun X, 2019, Study on the Impact of Different Gastric Tube Insertion Lengths on Nutritional Improvement in Patients with Cerebral Infarction on Long-Term Nasogastric Feeding. China Medical Device Information, 25(5): 156–157.
Li X, Shang S, 2010, Basic Nursing. 4th edition. People’s Medical Publishing House, Beijing.
Zuo J, Chen H, Lan H, et al., 2016, Comparison of the Effects of Three Gastric Tube Indwelling Lengths in Stroke Patients. Nursing Research, 30(14): 1755–1757.
Luo S, 2019, The Effect of Modified Gastric Tube Indwelling Length on Aspiration in Patients with Ischemic Stroke Complicated by Swallowing Disorders. Journal of Clinical Nursing, 18(1): 69–70.
Xiang F, Du C, 2020, The Effect of Extending the Insertion Depth of Nasogastric Tubes on the Aspiration Rate in Severe Stroke Patients. China Continuing Medical Education, 12(28): 189–192.
Chen H, 2016, The Effect of Different Lengths of Gastric Tube Indwelling in Stroke Patients. Chinese Journal of Modern Nursing, 22(6): 761–765.
Wang X, 2018, Clinical Study on the Length of Indwelling Gastric Tube for Acute Stroke Patients with Dysphagia. China Continuing Medical Education, 10(25): 156–158.
Lu J, et al., 2018, The Application Effect of Modified Gastric Tube Indwelling Length in Patients with Dysphagia After Stroke. Electronic Journal of Integrated Traditional Chinese and Western Medicine Cardiovascular Diseases, 6(31): 29–32.
Wu X, Ni Y, 2006, Discussion on Nasogastric Tube Feeding and Esophageal Reflux in Stroke Patients. Journal of Jiangxi Medical College, 2006(2): 155–157.
Zhang Y, Zhang Y, Cao J, 2011, Clinical Study on the Length of Indwelling Gastric Tube for Acute Stroke Patients with Dysphagia. Chinese Journal of Modern Nursing, 2011(12): 1372–1374.
Chen C, Lin Z, 2018, Application of NEX+10cm Nasogastric Tube Insertion Depth in Patients with Acute Ischemic Stroke and Swallowing Disorders. Nursing Practice and Research, 15(9): 131–132.
Han A, Cao Y, Wang Q, et al., 2018, Meta-Analysis of the Efficacy of Hyperbaric Oxygen Therapy for Post-Stroke Dysphagia. Chinese Journal of Public Health, 34(9): 1299–1302.
Taylor SJ, Allan K, McWilliam H, et al., 2014, Nasogastric Tube Depth: The ‘NEX’ Guideline is Incorrect. The British Journal of Nursing, 23(12): 641–644.
Liu M, 2017, Research Progress on Nasogastric Tube Length for Severe Stroke Patients with Swallowing Disorders. Inner Mongolia Medical Journal, 49(3): 297–299.
Hou J, Xin Z, Wang C, 2016, The Impact of Ultra-Early Gastric Tube Placement on Clinical Nursing Outcomes for Severe Stroke Patients. Chinese Journal of Practical Nervous Diseases, 19(21): 130–131.
Fang P, Li D, Liu Q, et al., 2016, Application of Lateral Position with Healthy Nostril Uppermost and Twisting Gastric Tube Placement Method in Stroke Patients with Paralysis. Journal of Nursing Science, 31(15): 43–44.
Chen H, Lan H, Deng L, et al., 2015, Evaluation of the Effectiveness of Modified Gastric Tube Indwelling Length in Stroke Patients. Journal of Nursing Management, 15(2): 145–147.
Chen H, Deng L, Wang Y, et al., 2014, Evidence-Based Nursing Practice and Evaluation of the Effectiveness of Gastric Tube Indwelling Length in Stroke Patients. Journal of Nurses Training, 29(23): 2132–2135.