中国食管癌术后患者混合营养的疗效和安全性评估:荟萃分析

Shui Liu, Lin Qiao, Yang Liu, Hangmei Liu, Yiwen Li, Jingbo Sun, Wei Chen, Rongguo Shang, Lili Zhang, Xiaochuan Liu
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摘要

通过检索PubMed、Web of Science、Cochrane、CNKI、万方等数据库,筛选了截至2024年3月有关食管癌术后患者混合营养与肠外营养支持随机对照试验(RCT)比较的所有文献。纳入标准为患者来自中国的随机对照试验或临床试验,且患者均经病理活检确诊为食管癌。排除标准为上述以外的文献,包括重复发表的文献、非中英文文献、分析数据不完整或缺失等。两名研究人员独立筛选文献、提取数据并根据标准评估偏倚风险后,使用RevMan 5.4软件进行了Meta分析。Meta分析表明,与肠外营养相比,混合营养可提高食管癌术后患者转铁蛋白、血清白蛋白、前白蛋白和淋巴细胞计数水平,缩短术后肛门排气、排便和住院恢复时间,降低肺部感染、腹胀、切口感染和吻合口瘘的发生率,两组比较差异有统计学意义(P<0.05)。本研究个体结果异质性较高,分析来源于临床异质性,通过漏斗图分析发表偏倚。以肺部感染发生率为例,两组结果均匀分布在漏斗图两侧,发表偏倚对研究结果影响不大。与肠外营养相比,混合营养可改善食管癌术后患者的预后,降低相关不良事件的发生率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy and safety evaluation of mixed nutrition for postoperative esophageal cancer patients in China: a meta-analysis
The purpose of this study was to evaluate the clinical effect of mixed nutrition and parenteral nutrition support on postoperative patients with esophageal cancer.By searching PubMed, Web of Science, Cochrane, CNKI, Wanfang and other databases, all the literatures until March 2024 about the comparison of randomized controlled Trial (RCT) of mixed nutrition and parenteral nutrition support in postoperative patients with esophageal cancer were screened. The inclusion criteria were that the patients were from randomized controlled trials or clinical trials in China, and the patients were all diagnosed with esophageal cancer by pathological biopsy. The exclusion criteria were the literature other than the above, including repeated published literature, non-Chinese and English literature, incomplete or missing analysis data, etc. After two researchers independently screened the literature, extracted the data and evaluated the risk of bias according to the criteria, Meta-analysis was carried out with RevMan 5.4 software.A total of 11 studies were included, including 1216 patients. Meta-analysis showed that, compared with parenteral nutrition, mixed nutrition can improve the levels of transferrin, serum albumin, prealbumin and lymphocyte counts in patients with esophageal cancer after surgery, shorten the time of anal recovery of exhaust, defecation and hospital stay after surgery, and reduce the incidence of pulmonary infection, abdominal distension, incision infection and anastomotic fistula, with statistical significance between the two groups (P < 0.05). The heterogeneity of individual results in this study is relatively high, the analysis comes from clinical heterogeneity, and the publication bias is analyzed through Funnel plot. Taking the incidence of lung infection as an example, the results are evenly distributed on both sides of the Funnel plot, and the publication bias has little impact on the results of the study.Compared with parenteral nutrition, mixed nutrition can improve the prognosis of postoperative patients with esophageal cancer and reduce the incidence of related adverse events.
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