先天性十二指肠梗阻患儿术后早期进行肠内营养安全性和有效性的Meta分析  

Safeness and effectiveness of postoperative early enteral nutrition in children with congenital duodenal obstruction:a Meta⁃analysis

作　　者：彭美晴 张亚南 王雯 付秀云 谢婉花 PENG Meiqing;ZAHNG Yanan;WANG Wen;FU Xiuyun;XIE Wanhua(Department of Gastrointestinal Surgery,Affiliated Women and Children's Medical Center of Guangzhou Medical University,Guangzhou 510623,Guangdong,China;Department of Ophthalmology,Affiliated Women and Children's Medical Center of Guangzhou Medical University,Guangzhou 510623,Guangdong,China;Department of Psychogeriatrics,the Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510370,Guangdong,China;Department of Central Outpatient,Affiliated Women and Children's Medical Center of Guangzhou Medical University,Guangzhou 510623,Guangdong,China)

机构地区：[1]广州医科大学附属妇女儿童医疗中心胃肠外科,广东省广州市510623 [2]广州医科大学附属妇女儿童医疗中心眼科,广东省广州市510623 [3]广州医科大学附属脑科医院老年精神科,广东省广州市510370 [4]广州医科大学附属妇女儿童医疗中心门诊部,广东省广州市510623

出　　处：《广西医学》2024年第9期1394-1402,共9页Guangxi Medical Journal

基　　金：广州市科技局基础研究项目(2023A03J0913)。

摘　　要：目的 系统评价先天性十二指肠梗阻(CDO)患儿术后早期肠内营养(EEN)的安全性和有效性。方法 计算机检索The Cochrane Library、Web of Science、PubMed、EBSCO、中国知网、万方数据知识服务平台和维普中文期刊服务平台等数据库,纳入有关CDO患儿术后进行EEN的随机对照研究和回顾性队列研究。对纳入文献进行筛选、资料提取和质量评价后,采用RevMan 5.4软件进行Meta分析。结果 共纳入6篇文献,包含307例CDO患儿,其中EEN组145例,延迟肠内营养(DEN)组162例。Meta分析结果显示,与DEN组相比,EEN组患儿的住院时间、术后肠外营养使用时间、术后达到全肠内营养的时间更短(P<0.05),两组患儿呕吐发生率差异无统计学意义(P>0.05),所有的研究均未报告存在坏死性小肠结肠炎(NEC)和败血症的病例。结论 术后24~48 h内进行EEN有利于缩短CDO术后患儿的住院时间、术后肠外营养使用时间、达到全肠内营养的时间,且不增加NEC和败血症等并发症的发生风险。Objective To systematically evaluate the safeness and effectiveness of postoperative early enteral nutrition(EEN)in children with congenital duodenal obstruction(CDO).Methods The randomized controlled trials and retrospective cohort studies related to postoperative EEN in CDO children were enrolled by retrieving the databases of The Cochrane Library,Web of Science,PubMed,EBSCO,China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,and VIP,etc.After screening,data extracting,and quality evaluating of the enrolled literature,the RevMan 5.4 software was employed to perform Meta-analysis.Results A total of 6 literature was enrolled,containing 307 CDO children,therein there were 145 cases in the EEN group,and 162 cases in the delayed enteral nutrition(DEN)group.The results of Meta-analysis revealed that compared with the DEN group,the EEN group exhibited shorter length of hospital stay,time to postoperative parenteral nutrition use,and time to postoperative total enteral nutrition achieved(P<0.05).There was no statistically significant difference in the incidence rate of vomiting between the two groups(P>0.05).No cases of necrotizing enterocolitis(NEC)or sepsis was reported in any of the studies.Conclusion EEN after 24 hours to 48 hours of operation is helpful for shortening length of hospital stay,postoperative time to parenteral nutrition use,and time to total enteral nutrition achieved in CDO children,and it does not increase the occurrence risk of complications in terms of NEC and sepsis,etc.

关 键 词：早期肠内营养 先天性十二指肠梗阻 术后加速康复 肠外营养 META分析 

分 类 号：R726.5[医药卫生—儿科]