肠内营养在人工膝关节置换术患者中应用效果的Meta分析  

Effecs of Enternal Nutrition in Patients Following Total Knee Arthroplasty: A Meta-analysis

作　　者：何洁[1,2] 张玉梅[2] 黄陈[3] 朱京慈[1] HE Jie ZHANG Yu-mei HUANG Chen ZHU Jing-ci(Department of Teaching and Researching Section of Nursing, Third Military Medical University, Chongqing 400038, China Department of Orthopaedics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China Department of Nutriology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China)

机构地区：[1]第三军医大学护理学院基础护理学教研室,重庆400038 [2]第三军医大学新桥医院骨科,重庆400037 [3]第三军医大学新桥医院营养科,重庆400037

出　　处：《中国食物与营养》2017年第8期84-88,共5页Food and Nutrition in China

摘　　要：目的:系统评价肠内营养在人工膝关节置换术患者中的应用效果。方法:通过计算机检索Pubmed、Embase、Cochrane Library、Ebsco(CINAHL)、Sciencedirect、Springer,中国知网、万方、中国生物医学文献数据库、维普数据库,纳入实验组以肠内营养为干预措施,对照组为安慰剂的随机对照研究,并按Cochrane的系统评价方法,由2位评价员根据相关标准各自独立对文献进行评价及数据提取。结果:共纳入4项研究,总样本量为320例,其中实验组166例、对照组154例。Meta分析结果显示,实验组与对照组比较,术后两周[SMD=0.46,95%CI(-0.05,0.97)]与术后4~6周[SMD=0.61,95%CI(-0.05,1.28)]的股四头肌肌力的比较,差异均无统计学意义(P>0.05)。但进行亚组分析后得出术后股四头肌肌力[SMD=-0.30,95%CI(0.16,0.85)],差异有统计学意义(P<0.05);两组住院时间[SMD=-0.37,95%CI(-0.61,-0.12)]以及术后两周疼痛评分[SMD=-0.27,95%CI(-0.51,-0.02)]的的比较,差异均具有统计学意义(P<0.05)。结论:肠内营养的应用可以改善TKA患者术后股四头肌肌力,并能降低患者的疼痛水平以及缩短住院时间,但由于纳入的文献数量以及相关结局指标较少,肠内营养对于促进术后康复,以及减少TKA患者术后并发症的发生等方面,尚需更多高质量的研究来进一步确证其成效。Objective To evaluate the effect of enternal nutrition on outcome of patients following total knee arthroplasty. Method All randomized controlled trials（ RCTs） concerning the effect of enternal nutrition on the outcome of patients following total knee arthroplasty were identified from PubM ed,Embase,the Cochrane Library,Ebsco（ CINAHL）,Sciencedirect,Springer,CNKI,Wanfang,CBM,and VIP Database. Meta-analysis was conducted by using the statistical software RevM an 5. 3 and the quality of the RCTs was strictly evaluated by the Cochrane Handbook. Result A total of 4 RCTs involving 320 patients（ 166 patients in the enternal nutrition group and 154 patients in the control group） were included in this study. Statistical differences were found between the two groups in the strength of quadriceps 2 weeks and 4-6 weeks after surgery through subgroup analysis [SMD = 3. 00,95% CI（ 1. 01,4. 99） ],length of stay [SMD =-0. 30,95% CI（-0. 49,-0. 11） ],and pain score 2 weeks after surgery [SMD =-0. 32,95% CI（-0. 62,-0. 03） ]. Conclusion Patients with enternal nutrition could improve the strength of quadriceps after surgery,and decrease the pain level and length of stay. However,the efficacy of enternal nutrition needs further investigation in high-quality evidence in the future.

关 键 词：膝关节置换 肠内营养 营养添加剂 META分析 

分 类 号：R459.3[医药卫生—治疗学] R687.4[医药卫生—临床医学]