透析中进食对透析期间低血压及低血糖发生率影响的Meta分析

    Meta-analysis of the effect of eating during dialysis on the incidence of hypotension and hypoglycemia during dialysis

    • 摘要: 目的 系统评价患者透析期间进食对透析期间低血压及低血糖发生率的影响。方法 计算机检索PubMed、Web of Science、MEDLINE、The Cochrane library、Joanna Briggs Institute Library、CBM、CNKI、万方数据库及中国维普全文数据库从建库至2020年5月关于透析期间进食的相关文献,由2名评价者共同筛选,并按照2011年Cochrane手册质量标准,独立评价并交叉核对纳入研究的质量,用RevMan 5.3软件进行统计处理。结果 共纳入10篇中、英文文献,样本量479例,透析共6790例次。Meta分析结果显示,透析中进食患者的低血压发生率高于透析中不进食患者(RR=1.48,95%CI 1.03~2.13,P<0.05),透析开始后3 h后进食患者的低血压发生率高于透析开始后3 h内进食患者(RR=0.31,95%CI 0.23~0.43,P<0.01),而透析中进食患者的低血糖发生率低于透析中不进食患者(RR=0.24,95%CI 0.11~0.48,P<0.01)。结论 透析期间应做好血糖和血压的监控,采用个体化饮食管理,对于透析期间有低血压风险的患者应禁食,有低血糖风险的患者则鼓励进食。

       

      Abstract: Objective To systematically evaluate the effect of eating on the incidence of hypotension and hypoglycemia during dialysis.Methods The relevant literature on eating during dialysis were retrieved from the databases of PubMed,Web of Science,MEDLINE,Cochrane Library,Joanna Briggs Institute Library,CBM,CNKI,WanFang Database and VIP.And the retrieval time was from the establishment of the database to May 2020.Two reviewers jointly selected and independently evaluated and cross-checked the quality of included studies according to the standards of 2011 Cochrane Handbook.RevMan 5.3 was employed for statistical processing.Results A total of 10 articles in Chinese and English were included with a sample size of 479 cases and a total of 6790 cases of dialysis.Meta-analysis revealed that the incidence of hypotension was higher when eating during dialysis(RR=1.48,95%CI 1.03~2.13,P<0.05).And the incidence of hypotension when eating 3 hours after dialysis was higher than that when eating within 3 hours after dialysis(RR=0.31,95%CI 0.23~0.43,P<0.01) while the incidence of hypoglycemia was lower(RR=0.24,95%CI 0.11~0.48,P<0.01).Conclusions Blood glucose and blood pressure should be monitored during dialysis and individualized diet management adopted.Fasting should be recommended for patients at risk of hypotension during dialysis and eating encouraged for those at risk of hypoglycemia.

       

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