甲状腺切除患者术前口服碳水化合物效果的meta分析  

Meta-analysis of preoperative oral carbohydrate effects in patients with thyroidectomy

作　　者：刘洁 韩鹏 隋芳 闫金凤[1] 张玺平 侯唤 毕莹 LIU Jie;HAN Peng;SUI Fang;YAN Jinfeng;ZHANG Xiping;HOU Huan;BI Ying(Department of Otolaryngology Head and Neck surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 710061,China)

机构地区：[1]西安交通大学第一附属医院耳鼻咽喉头颈外科,陕西西安710061

出　　处：《中华全科医学》2025年第1期143-147,共5页Chinese Journal of General Practice

基　　金：陕西省自然科学基础研究基金项目(2022JQ-834)。

摘　　要：目的通过meta分析评价国内外有关术前口服碳水化合物对甲状腺切除患者围手术期的有效性及安全性,以指导患者术前正确口服碳水化合物。方法利用知网、维普、万方、PubMed、EMbase、Web of Science、Wiley Online Library等中英文数据库检索相关的随机对照试验,检索时间为建库至2021年3月21日,根据纳入排除标准由2名研究者独立进行文献筛选及资料提取,采用RevMan软件(5.3版)对文献进行质量评价及meta分析。结果16篇随机对照试验纳入研究,共计1793例患者。试验组为术前口服碳水化合物,对照组为术前常规禁饮食,结果显示:术前口干口渴指标[95%CI(-2.39~-0.47),P=0.003],术后恶心呕吐指标[95%CI(0.41~0.80),P=0.001],胰岛素抵抗指数指标[95%CI(-2.73~-0.69),P=0.001],术后首次下床活动时间指标[95%CI(-1.56~-0.87),P<0.01],术后首次进食时间指标[95%CI(-1.07~-0.13),P=0.010],住院时间指标[95%CI(-2.67~-1.55),P<0.01],术后并发症数指标[95%CI(0.08~0.32),P<0.01],均为试验组优于对照组(P<0.05)。结论与常规护理相比,术前口服碳水化合物对甲状腺切除患者围手术期的影响是安全且有益的,具有良好的临床应用价值。Objective To evaluate the efficacy and safety of preoperative oral carbohydrate in patients with thyroidectomy during the perioperative period by meta-analysis,and to guide the clinical implementation.Methods CNKI,VIP,Wanfang,PubMed,Embase,Web of Science,Wiley Online Library,and other Chinese and English databases were used to search related RCT.The retrieval period was from the establishment of the database to March 21,2021.According to the inclusion and exclusion criteria,literature screening and data extraction were conducted independently by two researchers.RevMan software(version 5.3)was used for literature quality evaluation and meta-analysis.Results Sixteen randomized controlled trials involving 1793 patients were included in the study.The experimental group was given oral carbohydrate before surgery,while the control group was given a conventional diet before surgery,The results showed as follows:preoperative indexes of dry mouth and thirst[95%CI(-2.39,-0.47),P=0.003],postoperative indexes of nausea and vomiting[95%CI(0.41,0.80),P=0.001],indexes of insulin resistance[95%CI(-2.73,-0.69),P=0.001],the first time to get out of bed after surgery[95%CI(-1.56,-0.87),P<0.01],the first time to eat after surgery[95%CI(-1.07,-0.13),P=0.010],the number of hospitalization days[95%CI(-2.67,-1.55),P<0.01],and the number of postoperative complications[95%CI(0.08,0.32),P<0.01],indicating that the experimental group was better than the control group(P<0.05).Conclusion Compared with conventional care,preoperative oral carbohydrate is safe and beneficial in the perioperative period of patients with thyroidectomy,and has good clinical application value.

关 键 词：甲状腺切除患者 术前口服碳水化合物 META分析 

分 类 号：R653[医药卫生—外科学]