术前肠内营养对结直肠癌病人术后康复影响的Meta分析  

Effects of preoperative enteral nutrition on postoperative rehabilitation of colorectal cancer patients:a Meta-analysis

作　　者：张锐[1] 叶向红 王慧君 薛阳阳 ZHANG Rui;YE Xiang-hong;WANG Hui-jun;XUE Yang-yang(Medical College,Nanjing University,Nanjing 210093,Jiangsu,China;General Hospital of Eastern Theater Command,Research Institute of General Surgery,Nanjing 2X0002,Jiangsu,China;Graduate School,Bengbu Medical College,Bengbu 233000,Anhui,China)

机构地区：[1]南京大学医学院,江苏南京210093 [2]东部战区总医院普通外科研究所,江苏南京210002 [3]蚌埠医学院研究生院,安徽蚌埠233000

出　　处：《肠外与肠内营养》2021年第3期171-177,共7页Parenteral & Enteral Nutrition

基　　金：军事医学创新工程项目(18CXZ040)。

摘　　要：目的:通过Meta分析探讨术前肠内营养(EN)对结直肠癌病人术后康复的影响。方法:计算机检索中国知网、万方、维普、PubMed、Web Of Science、OVID、Cochrane数据库中结直肠癌病人术前EN与传统术前饮食(术前普通饮食,不额外补充营养)对病人术后恢复影响的随机对照研究。2名研究者分别对纳入文献质量进行评价后,用RevMan 5.3进行统计分析。结果:共纳入9篇术前EN对结直肠癌病人术后影响的文章。经Meta分析,术后3 d的总蛋白、前白蛋白以及白蛋白水平的测量结果有显著差异,分别为(MD=7.35,95%CI:1.72~12.98,P=0.01)、(MD=15.07,95%CI:12.48~17.67,P<0.05)、(MD=10.89,95%CI:5.15~16.62,P<0.05);术后首次肛门排气时间测量结果为(SMD=-1.24,95%CI:-1.90~-0.59,P<0.05);病人术后感染性并发症发生状况的测量结果为(OR=0.62,95%CI:0.42~0.93,P=0.02);但住院时间差异无统计学意义。结论:结直肠癌病人术前给予EN能改善病人术后营养状况,加速病人术后肠道功能恢复,减少术后感染性并发症的发生率,促进病人术后康复,但仍需更多高质量的随机对照研究佐证研究结果。Objective:To explore the effect of preoperative enteral nutrition on postoperative rehabilitation of patients with colorectal cancer by Meta-analysis.Methods:Randomized controlled trails on the effects of preoperative enteral nutrition and traditional preoperative diet on postoperative colorectal cancer patients were searched in the databases of CNKI,Wanfang,VIP,PubMed,Web of Science,OVID and Cochrane.After quality evaluation by two researchers,the literature were statistically analyzed by RevMan5.3.Results:Nine studies concerning the effect of preoperative enteral nutrition on postoperative outcomes of colorectal cancer patients were included.Significant differences were found among the levels of total protein,proprotein and albumin at 3 days after operation and the results were(MD=7.35,95%CI:1.72~12.98,P=0.01),(MD=15.07,95%CI:12.48~17.67,P<0.05)and(MD=10.89,95%CI:5.15~16.62,P<0.05),respecticely.Furthermore,the results of the first flatus time was(SMD=-1.24,95%CI:-1.90~-0.59,P<0.05),and the results of the incidence of infectious complications was(OR=0.62,95%CI:0.42~0.93,P=0.02),but there was no significant difference in the time of hospital stay.Conclusion:In colorectal cancer patients,preoperative enteral nutrition can improve postoperative nutritional status and accelerate the recovery of intestinal function.In addition,it can also reduce the incidence of postoperative infectious complications.However,more highquality randomized controlled trials are needed to support the results.

关 键 词：结直肠癌 术前肠内营养 术后康复 META分析 

分 类 号：R459.3[医药卫生—治疗学]