| 崔培荣,刘静静,张敏.胰十二指肠切除术后患者早期肠内营养对并发症、住院时间及治疗费用影响的Meta分析[J].上海护理,2024,24(S1): |
| 胰十二指肠切除术后患者早期肠内营养对并发症、住院时间及治疗费用影响的Meta分析 |
| Meta-analysis of the effect of early enteral nutrition on complications, length of hospital stay, and cost of treatment in patients after pancreaticoduodenectomy |
| DOI： |
| 中文关键词: 胰十二指肠切除术 早期肠内营养 胃肠外营养 并发症 Meta分析 |
| 英文关键词:postoperative pancreaticoduodenectomy early enteral nutrition parenteral nutrition complications Meta-analysis |
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| 中文摘要: |
| 目的 对胰十二指肠切除术（pancreaticoduodenectomy，PD）术后患者早期肠内营养（early enteral nutrition，EEN）较胃肠外营养（parenteral nutrition，PN）对并发症、住院时间及治疗费用的影响进行meta分析。方法 计算机检索Pubmed、Embase、Ovid Medline、The Cochrane Library、CINAHL、中国生物医学文献库、CNKI、万方和维普数据库，搜集有关PD术后患者营养支持的研究，检索时限均从建库至2024年1月9日。根据《Cochrane手册》评价纳入文献的方法学质量，应用RevMan5.2软件进行meta分析。结果 共纳入11篇RCT研究，共计978例患者。Meta分析结果显示，与PN组比较，EEN组并发症总发生率（OR=0.54，95%CI：0.40～0.72，P<0.001）、感染发生率（OR=0.45，95%CI：0.28～0.72，P<0.001）、住院时间（MD=-2.90，95%CI：-3.50～-2.29，P<0.001）、治疗费用（MD=-1.58，95%CI：-2.02～-1.14，P<0.001）较低，差异有统计学意义（P<0.05）；胰瘘发生率（OR=0.71，95%CI：0.41～1.23，P=0.22）、胆瘘发生率（OR=0.52，95%CI：0.24～1.13，P=0.10）、胃瘫发生率（OR=0.75，95%CI：0.42～1.40，P=1.36）、术后出血发生率（OR=0.63，95%CI：0.23～1.72，P=0.36）组间比较，差异均无统计学意义（P>0.05）。结论 PD患者术后EEN可减少并发症总发生率、感染发生率，缩短住院时间，同时降低治疗费用，因此可考虑实施EEN。本研究纳入文献的方法学质量中等，尚需高质量随机对照试验进一步验证以上结论。 |
| 英文摘要: |
| Objective Meta-analysis was used to analyze the effect of early enteral nutrition (EEN) compared with parenteral nutrition (PN) on complications,length of hospital stay, and treatment cost in postoperative pancreaticoduodenectomy (PD) patients. Methods The Pubmed,Ovid,Embase,PsycINFO,CINAHL Complete,Web of science,CNKI,WanFang,VIP,Sinomed databases were searched for studies on nutritional support for postoperative patients with PD from their inception up to January 9, 2024. The methodological quality of the included literature was evaluated according to the Cochrane Handbook, and meta-analysis was performed by applying RevMan 5.2 software. Results A total of 11 RCTs with 978 patients were included.Meta-analysis showed that compared with the PN group, the overall complication rate（OR=0.54，95%CI：0.40～0.72，P<0.001）, infection rate（OR=0.45，95%CI：0.28～0.72，P<0.001）, length of hospital stay in the EEN group（MD=-2.90，95%CI：-3.50～-2.29，P<0.001）, and treatment cost（MD=-1.58，95%CI：-2.02～-1.14，P<0.001）were lower, and the difference was statistically significant (P<0.05); and the incidence of pancreatic fistula（OR=0.71，95%CI：0.41～1.23，P=0.22）, incidence of biliary fistula（OR=0.52，95%CI：0.24～1.13，P=0.10）, incidence of delayed gastric emptying（OR=0.75，95%CI：0.42～1.40，P=1.36）, and incidence of postoperative hemorrhage（OR=0.63，95%CI：0.23～1.72，P=0.36）were compared between groups. None of the differences were statistically significant (P>0.05). Conclusion Postoperative EEN in PD patients can reduce the overall complications, infection incidence, length of hospital stay, and treatment cost, so EEN can be considered.The methodological quality of the literature included in this study was low, and high-quality randomized controlled trials are needed to further validate the above conclusions. |
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