肝癌病人手术后早期肠内营养支持疗效的Meta分析

发布时间：2018-11-21 15:49

【摘要】：目的:系统评价我国肝癌病人肿瘤切除术后早期肠内营养(EEN)支持的疗效。方法:计算机检索中国知网、万方数据库、维普数据库和中国生物医学文献数据库,检索肝癌切除术后EEN支持的国内随机对照研究文献,对符合要求的文献采用Rev Man5.3软件进行Meta分析。结果:纳入7项临床随机对照研究共460例病人。Meta分析结果显示,肝癌切除术后,EEN支持与肠外营养(PN)组相比,血清清蛋白(ALB)水平较高(WMD=1.17,95%CI:0.45~1.89,P=0.001),转氨酶较低(WMD=-3.95,95%CI:-7.08~-0.81,P=0.01),并缩短胃肠道功能恢复时间(WMD=-14.11,95%CI:-19.58~-8.56,P0.000 01);而在营养支持后病人的体重变化和胃肠道不良反应均无统计学差异。结论:肝癌切除术后早期给予EN支持可改善病人营养代谢,促进肝功能和胃肠道功能早期恢复。
[Abstract]:Objective: to evaluate the efficacy of early enteral nutrition (EEN) support in patients with hepatocellular carcinoma (HCC) after tumor resection. Methods: a computer search was conducted for the Chinese knowledge Network, Wanfang Database, Weip Database and Chinese Biomedical Literature Database, and the domestic randomized controlled study literature supported by EEN after hepatectomy was searched. Rev Man5.3 software was used for Meta analysis of the documents that meet the requirements. Results: a total of 460 patients were enrolled in 7 randomized controlled clinical trials. Meta analysis showed that after hepatectomy, the level of serum albumin (ALB) was higher in EEN support group than in parenteral nutrition (PN) group (WMD=1.17,95%CI:0.45~1.89, level was higher than that in parenteral nutrition (PN) group (P < 0.01). P0. 001), lower transaminase (WMD=-3.95,95%CI:-7.08~-0.81,P=0.01) and shorter recovery time of gastrointestinal function (WMD=-14.11,95%CI:-19.58~-8.56,P0.000 01); There was no significant difference in body weight and gastrointestinal adverse reactions after nutritional support. Conclusion: early EN support after hepatectomy can improve nutritional metabolism and promote early recovery of liver function and gastrointestinal function.
【作者单位】：武汉大学人民医院肝胆腔镜外科;
【分类号】：R735.7

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