肠内营养联合肠外营养治疗脑出血患者的Meta分析  

Meta Analysis of Enteral Nutrition Combined with Parenteral Nutrition in the Treatment of Patients with Cerebral Hemorrhage

作　　者：王昆鹏[1] 杨婕[2] 呼铁民[1] 孟杰[1] 闫丽娜[1] 周路琦[2] WANG Kun-peng YANG Jie HU Tie-min et al(Neurosurgery Department of the Affiliated Hospital of Chengde Medical College, Chengde 067000, Chin)

机构地区：[1]承德医学院附属医院神经外科,河北承德067000 [2]承德医学院附属医院营养科,河北承德067000

出　　处：《医学与哲学（B）》2016年第9期58-61,共4页Medicine & Philosophy(B)

基　　金：2014年承德市科技支撑计划项目;项目编号:201422029

摘　　要：系统评价脑出血患者术后实施不同营养治疗方法的临床疗效。经严格筛选纳入14个随机对照试验,共1 093例患者。Meta分析结果示:脑出血患者术后实施肠外营养(PN)结合肠内营养(EN)与单纯PN相比较,在升高患者术后血清白蛋白(ALB)[MD合并=3.78,95%CI(2.05,5.50);Z=4.29,P<0.000 1]和前白蛋白(PA)值[MD合并=72.15,95%CI(61.61,82.69);Z=13.41,P<0.000 01]、降低美国卫生研究院卒中量表评分(NIHSS)[MD合并=-5.43,95%CI(-6.60,-4.26);Z=9.09,P<0.000 01]、降低肺部感染率[RR合并=0.46,95%CI(0.32,0.67);Z=4.17,P<0.0001]和消化道出血率[RR合并=0.46,95%CI(0.31,0.68);Z=3.89,P<0.0001]等方面效果更显著。得出结论,脑出血患者术后联合应用EN+PN,能够改善患者术后营养状况,减少并发症。System evaluation of the clinical curative effect of different nutrition support method being used on patients with cerebral hemorrhage.14 randomized controlled trials had been bring into study,a total of 1093 patients.Meta analysis results show：for cerebral hemorrhage patients,parenteral nutrition（PN）combined with enteral nutrition（EN）compared with pure parenteral nutrition support,it has more significant effect in elevating serum albumin[MDmerger= 3.78,95%CI（2.05,5.50）;Z=4.29,P〈0.000 1）and prealbumin value[MDmerger=72.15,95%CI（61.61,82.69）;Z=13.41,P〈0.000 01）,reducing the National Institutes of Health Stroke Scale scores[MDmerger=-5.43,95%CI（-6.60,-4.26）;Z= 9.09,P〈0.000 01）,reducing the lung infection rate [RRmerger = 0.46,95%CI（0.32,0.67）;Z=4.17,P〈0.000 1]and gastrointestinal bleeding rate[RRmerger= 0.46,95%CI（0.31,0.68）;Z=3.89,P〈0.000 1].So the authors come to a conclusion,combined use of EN and PN in patients with cerebral hemorrhage after operation can improve nutritional status,reduce the complications of patients.

关 键 词：脑出血 肠内营养 肺部感染 美国卫生研究院卒中量表评分 META分析 

分 类 号：R743.34[医药卫生—神经病学与精神病学]