结肠癌患者术后肠内营养和肠外营养的Meta分析
刘文清 尚轶 潘惠佳 魏志红 王昌
【摘要】 目的 以肠内营养(enteral nutrition, EN) 和肠外营养(parenteral alimentation, PN)治疗为对比，评价结肠癌术后采用不同营养支持方式的安全性和有效性。 方法 检索Pubmed、CNKI、维普和万方数据库，《肠外与肠内营养》杂志，检索时间限定为1989~2015年，选择随机对照试验为研究对象，采用软件RevMan 5.3.5进行Meta分析。 结果 共纳入12项随机对照试验（RCT），1013例患者。Meta分析结果显示，与PN组比较，EN组显著性提高结肠癌术后患者体重[WMD=1.80，95%CI(0.99，2.62)]、血红蛋白含量［WMD=6.86，95%CI(1.19，12.53)］、总蛋白含量[WMD=1.69，95%CI(0.82，2.56)]、前白蛋白含量[WMD=17.17，95%CI(8.29，26.5)]和转铁蛋白含量[WMD=0.25，95%CI(0.15，0.36)]，缩短肛门排气时间[WMD=-1.07，95%CI(-1.36，-0.78)]，减少术后并发症的发生率[OR=0.36，95%CI(0.20，0.67)]。 结论 Meta分析结果表明，对结肠癌术后患者而言，采用EN进行营养支持，能增加患者体重，改善患者的营养状况，缩短患者的肛门排气时间，并显著降低术后并发症的发生率，建议临床推广使用。
【关键词】 结肠癌术后; 营养支持; 随机对照实验; Meta分析
Parenteral nutrition versus eteral nutrition for postoperative patients with colorectal cancer: a meta-analysis. Liu Wenqing, Shang Yi, Pan Huijia, Wei Zhihong, Lanzhou University Second Hospital, Lanzhou 730030, China. Wang Chang, School of Pharmacy, Lanzhou University, Lanzhou 730000, China
【Abstract】 Objective To evaluate the safety and efficacy of nutritional support between enteral nutrition and parenteral nutrition therapy in patients with colorectal cancer. Methods We searched PubMed, CNKI, VIP and Wanfang databases and retrieved issues of the "Parenteral and Enteral Nutrition" journal. The retrieval time was limited from 1989 to 2015 and the studies included were identified as randomized controlled trials. The studies were analyzed by the RevMan 5.3.5 software. Results Twelve randomized controlled trials (RCT) involving 1013 patients were included. The meta-analysis result showed that, compared with the PN group, EN could significantly improve weight [WMD=1.80, 95%CI(0.99, 2.62)], hemoglobin [WMD=6.86, 95%CI(1.19, 12.53)]; total protein [WMD=1.69, 95%CI(0.82, 2.56)], pre-albumin [WMD=17.17, 95%CI(8.29, 26.5)], transferrin protein [WMD=0.25, 95%CI(0.15, 0.36)], shorten the anal exhaust time [WMD=-1.07, 95%CI(-1.36, -0.78)], and reduce postoperative complications [OR=0.36, 95%CI(0.20, 0.67)]. Conclusion Meta-analysis shows that EN can improve the hemoglobin content, total protein content, pre-albumin content and transferrin content, shorten the anal exhaust time, and reduce postoperative complications when compared with PN. Consequently, EN should be considered a better choice in patients with colon cancer.
【Key words】 Colorectal cancer postoperative; Nutritional support; Randomized controlled trial; Meta-analysis