結(jié)腸癌患者術(shù)后腸內(nèi)營養(yǎng)和腸外營養(yǎng)的Meta分析
結(jié)腸癌患者術(shù)后腸內(nèi)營養(yǎng)和腸外營養(yǎng)的Meta分析
劉文清 尚軼 潘惠佳 魏志紅 王昌
【摘要】 目的 以腸內(nèi)營養(yǎng)(enteral nutrition, EN) 和腸外營養(yǎng)(parenteral alimentation, PN)治療為對比，評價結(jié)腸癌術(shù)后采用不同營養(yǎng)支持方式的安全性和有效性。 方法 檢索Pubmed、CNKI、維普和萬方數(shù)據(jù)庫，《腸外與腸內(nèi)營養(yǎng)》雜志，檢索時間限定為1989~2015年，選擇隨機(jī)對照試驗(yàn)為研究對象，采用軟件RevMan 5.3.5進(jìn)行Meta分析。 結(jié)果 共納入12項(xiàng)隨機(jī)對照試驗(yàn)（RCT），1013例患者。Meta分析結(jié)果顯示，與PN組比較，EN組顯著性提高結(jié)腸癌術(shù)后患者體重[WMD=1.80，95%CI(0.99，2.62)]、血紅蛋白含量［WMD=6.86，95%CI(1.19，12.53)］、總蛋白含量[WMD=1.69，95%CI(0.82，2.56)]、前白蛋白含量[WMD=17.17，95%CI(8.29，26.5)]和轉(zhuǎn)鐵蛋白含量[WMD=0.25，95%CI(0.15，0.36)]，縮短肛門排氣時間[WMD=-1.07，95%CI(-1.36，-0.78)]，減少術(shù)后并發(fā)癥的發(fā)生率[OR=0.36，95%CI(0.20，0.67)]。 結(jié)論 Meta分析結(jié)果表明，對結(jié)腸癌術(shù)后患者而言，采用EN進(jìn)行營養(yǎng)支持，能增加患者體重，改善患者的營養(yǎng)狀況，縮短患者的肛門排氣時間，并顯著降低術(shù)后并發(fā)癥的發(fā)生率，建議臨床推廣使用。
【關(guān)鍵詞】 結(jié)腸癌術(shù)后; 營養(yǎng)支持; 隨機(jī)對照實(shí)驗(yàn); Meta分析
Parenteral nutrition versus eteral nutrition for postoperative patients with colorectal cancer: a meta-analysis. Liu Wenqing, Shang Yi, Pan Huijia, Wei Zhihong, Lanzhou University Second Hospital, Lanzhou 730030, China. Wang Chang, School of Pharmacy, Lanzhou University, Lanzhou 730000, China
【Abstract】 Objective To evaluate the safety and efficacy of nutritional support between enteral nutrition and parenteral nutrition therapy in patients with colorectal cancer. Methods We searched PubMed, CNKI, VIP and Wanfang databases and retrieved issues of the "Parenteral and Enteral Nutrition" journal. The retrieval time was limited from 1989 to 2015 and the studies included were identified as randomized controlled trials. The studies were analyzed by the RevMan 5.3.5 software. Results Twelve randomized controlled trials (RCT) involving 1013 patients were included. The meta-analysis result showed that, compared with the PN group, EN could significantly improve weight [WMD=1.80, 95%CI(0.99, 2.62)], hemoglobin [WMD=6.86, 95%CI(1.19, 12.53)]; total protein [WMD=1.69, 95%CI(0.82, 2.56)], pre-albumin [WMD=17.17, 95%CI(8.29, 26.5)], transferrin protein [WMD=0.25, 95%CI(0.15, 0.36)], shorten the anal exhaust time [WMD=-1.07, 95%CI(-1.36, -0.78)], and reduce postoperative complications [OR=0.36, 95%CI(0.20, 0.67)]. Conclusion Meta-analysis shows that EN can improve the hemoglobin content, total protein content, pre-albumin content and transferrin content, shorten the anal exhaust time, and reduce postoperative complications when compared with PN. Consequently, EN should be considered a better choice in patients with colon cancer.
【Key words】 Colorectal cancer postoperative; Nutritional support; Randomized controlled trial; Meta-analysis