摘要
目的对不同时机营养支持治疗胰十二指肠切除患者的术后效果进行比较。方法计算机检索PubMed、Embase、The Cochrane Library、Web of Science、CNKI、万方、维普和CBM数据库,搜集胰十二指肠切除患者营养支持的RCT,检索时间为数据库建库至2019年3月1日止。由两名研究者各自进行文献筛选、信息提取并评价纳入研究的偏倚风险,继而以JAGS 3.4.0为运行环境,对R 3.5.3软件编码进行网状Meta分析。结果最终筛选所得8个RCTs,共825例患者。网状meta分析结果显示:在胰十二指肠切除患者住院时间和术后7 d白蛋白水平方面,不同时机肠内营养支持间的差异均无统计学意义(P>0.05)。排序概率图显示,术前给予肠内营养是胰十二指肠切除患者支持营养的较优方案,其次的给予时机是术后24~48 h。结论根据网状meta分析和概率排序结果,术前纠正患者营养状况,给予肠内营养的效果优于其他营养支持方式;其次,应结合欧洲临床营养和代谢学会(ESPEN)和快速康复外科(ERAS)的建议综合考虑,在手术后24~48 h之内给予肠内营养支持治疗。
Objective To systematically evaluate the effect of different enteral nutrition timing on patients with pancreaticoduodenectomy.Methods PubMed,Embase,The Cochrane Library,Web of Science,CBM,CNKI,WanFang Data,and VIP databases were searched to collect RCTs for nutritional support in pancreaticoduodenectomy patients.The search time was established until March 12019.After two independent investigators conducted literature screening,data extraction,and evaluation of the risk of bias in the included studies,a meta-metabolic analysis was performed using the R 3.5.3 software gemtc package,JAGS 3.4.0,and Revman software.Results A total of 8 RCTs were included,for a total of 825 patients.The results of reticular meta-analysis showed that there was no significant difference in the duration of hospitalization for patients with pancreaticoduodenectomy,between the enteral nutrition supported at different timing.The results of the ranking probability map suggested that preoperative enteral nutrition was a better option for supporting nutrition in patients with pancreaticoduodenectomy,secondly,timing to give was 24–48 hours after operation.Conclusions According to the results of mesh meta-analysis and probabilistic ranking,the nutritional status of patients is corrected before surgery,and the effect of enteral nutrition is better than other nutritional support methods.Secondly,enteral nutrition should be given at 24–48 hours after operation in combination with ESPEN and ERAS recommendations.
作者
刘晓燕
柴长鹏
张有娣
周文策
LIU Xiaoyan;CHAI Changpeng;ZHANG Youdi;ZHOU Wence(School of Nursing of Lanzhou University,Lanzhou 730000,P.R.China;The Second Department of General Surgery,The First Hospital of Lanzhou University,Lanzhou 730000,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2019年第12期1452-1460,共9页
Chinese Journal of Bases and Clinics In General Surgery
