肠外免疫营养制剂对结直肠癌病人术后影响的Meta分析  

Impact of enteral immunonutrition formulations on postoperative in patients with colorectal cancer:a Meta-analysis

作　　者：张梦丽 薛芳 ZHANG Mengli;XUE Fang(School of Nursing,Bengbu Medical University,Anhui 233030 China)

机构地区：[1]蚌埠医科大学护理学院,安徽233030

出　　处：《循证护理》2024年第19期3442-3447,共6页Chinese Evidence-Based Nursing

基　　金：蚌埠医学院人文社会科学重点研究项目,编号:2022byzd115sk。

摘　　要：目的:系统评价肠外免疫营养制剂对结直肠癌病人术后免疫功能和营养状况的影响。方法:计算机检索中国知网、万方数据库、中国生物医学文献数据库、维普数据库、PubMed、EMbase、the Cochrane Library、Web of Science关于结直肠癌根治术后病人相关的肠外免疫营养的随机对照试验文献。检索时限为建库至2023年7月1日。2位研究者按照纳入和排除标准对文献进行筛选,提取相关数据,并对文献质量进行评价。采用RevMan 5.4软件进行统计分析。结果:纳入10篇文献,涉及结直肠癌根治术后病人615例。Meta分析结果表明,两组CD_(4)^(+)T淋巴细胞[WMD=4.60,95%CI(3.28,5.92),Z=6.82,P<0.00001)]、CD 3+T淋巴细胞[WMD=3.79,95%CI(1.64,5.93),Z=3.46,P=0.0005]、辅助性与抑制性T细胞比例(CD_(4)^(+)/CD_(8)^(+))[WMD=0.34,95%CI(0.21,0.47),Z=5.16,P<0.00001]、免疫球蛋白A(IgA)[WMD=0.42,95%CI(0.34,0.51),Z=9.69,P<0.00001]、免疫球蛋白M(IgM)[WMD=0.19,95%CI(0.13,0.25),Z=6.15,P<0.00001]、血清清蛋白(ALB)[WMD=1.77,95%CI(1.15,2.39),Z=5.59,P<0.00001]、转铁蛋白(TRF)[WMD=0.29,95%CI(0.20,0.37),Z=6.68,P<0.00001]等比较,差异均有统计学意义。结论:现有证据表明,结直肠癌根治术后病人应用肠外免疫营养制剂可明显增强病人的免疫力并改善营养状况。Objective:To systematically evaluate the effects of enteral immunonutrition formulations on postoperative immune function and nutritional status in patients with colorectal cancer.Methods:A comprehensive search was conducted in CNKI,WanFang Database,CBM,VIP,PubMed,EMbase,the Cochrane Library,and Web of Science to collect randomized controlled trials related to parenteral immune nutrition in patients after radical surgery for colorectal cancer.The retrieval time was from the inception to July 1,2023.Two researchers screened the literature according to inclusion and exclusion criteria,extracted relevant data,and assessed the quality of the studies.Statistical analysis was performed using RevMan 5.4 software.Results:A total of 10 studies were included,involving 615 patients after radical surgery for colorectal cancer.The Meta-analysis results showed that CD_(4)^(+)(WMD=4.60,95%CI 3.28-5.92,Z=6.82,P<0.00001),CD 3+(WMD=3.79,95%CI 1.64-5.93,Z=3.46,P=0.0005),CD_(4)^(+)/CD_(8)^(+)(WMD=0.34,95%CI 0.21-0.47,Z=5.16,P<0.00001),immunoglobulin IgA(WMD=0.42,95%CI 0.34-0.51,Z=9.69,P<0.00001),immunoglobulin IgM(WMD=0.19,95%CI 0.13-0.25,Z=6.15,P<0.00001),ALB(WMD=1.77,95%CI 1.15-2.39,Z=5.59,P<0.00001),TRF(WMD=0.29,95%CI 0.20-0.37,Z=6.68,P<0.00001),all indicating statistically significant differences.Conclusion:Current evidence shows that enteral immunonutrition formulations emerges as a promising intervention to enhance immune function and nutritional status in patients with colorectal cancer following radical surgery.

关 键 词：肠外免疫营养 结直肠癌 META分析 循证护理 

分 类 号：R473.73[医药卫生—护理学]