结直肠癌患者术后早期与传统经口进食安全性和有效性的Meta分析

发布时间：2018-04-19 16:31

  本文选题：结直肠癌 + 结直肠外科手术　； 参考：《山西医科大学》2017年硕士论文

【摘要】：目的:利用Meta分析的方法,比较早期经口进食(EOF)与传统经口进食(TOF)对结直肠癌术后患者的影响。方法:计算机检索PubMed、SCI、Ovid、The Cochrane Library、CNKI、CBM、VIP及万方数据库,全面收集比较EOF和TOF两种不同干预措施对结直肠癌术后患者临床结局影响的随机对照试验(RCT),检索各数据库自建库以来至2016年6月1日收录的文献,2名研究者根据纳入排除标准进行筛选,提取资料,之后RevMan5.2处理数据。结果:共得到14篇RCT,1807名患者。EOF组患者术后首次排气时间[MD=-16.11h,95%CI(-18.27~-13.94 h),P0.00001],术后住院时间[MD=-1.92 d,95%CI(-2.83~-1.01 d),P0.0001],住院花费[MD=-0.58万元,95%CI(-0.71~-0.46万元),P0.00001]均少于TOF组。EOF组患者有更低的总并发症发生率[OR=0.68,95%CI(0.48~0.95),P=0.03],其中肺部感染[OR=0.27,95%CI(0.13~0.53),P=0.0002],咽部炎症[OR=0.06,95%CI(0.04~0.11),P0.00001]的发生率均明显低于TOF组,胃管再置[OR=2.34,95%CI(1.08~5.07),P=0.03]的发生率高于TOF组,两组间吻合口瘘、恶心呕吐、腹胀、腹泻、切口感染等发生均无统计学差异。从免疫水平来看,两组患者术后7天IgM无统计差异,但IgA[MD=0.3,95%CI(0.12~0.48),P=0.001],IgG[MD=2.13,95%CI(0.82~3.44),P=0.001],CD4+[MD=3.80,95%CI(2.55~5.04),P0.00001],CD4+/CD8+[MD=0.22,95%CI(0.04~0.41),P=0.02]均高于TOF组。炎性指标方面,患者术后CRP下降较快[MD=-30.10,95%CI(-48.07~-12.13),P=0.001],而IL-6差异无统计学意义。同时术后5天以上EOF组患者有更高的血清白蛋白水平[MD=3.27,95%CI(2.48~4.07),P0.00001]。结论:EOF可促进患者排气排粪,缩短术后住院时间,降低治疗费用,减少相关并发症的发生,并可能降低术后炎性反应及维护患者免疫功能,值得临床推广。
[Abstract]:Objective: to compare the effects of early oral feeding (EOF) and traditional oral feeding (TOF) on postoperative colorectal cancer patients by Meta analysis.Methods: a computer-based search was conducted for the Cochrane Library CNKICIM VIP and the Wanfang database.A randomized controlled trial was conducted to compare the effects of EOF and TOF interventions on the clinical outcomes of patients with colorectal cancer after surgery. Two documents collected from various databases up to June 1, 2016 were retrieved according to the results of the study.Inclusion of exclusion criteria for screening,Extract the data and then RevMan5.2 processes the data.缁撴灉:鍏卞緱鍒，

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