背景:我们进行了一项荟萃分析,以评估与正常口服饮食相比,家庭肠内营养支持对上消化道癌症切除术后受试者的影响。
方法:进行了截至2021年12月的系统文献检索,23项研究包括3,010名在研究开始时接受上消化道肿瘤切除术的受试者;其中1,556人给予家庭肠内营养支持,1,454人正常口服饮食。我们计算比值比(OR)和平均差异(MD)与95%CIs,以评估家庭肠内营养支持与正常口服饮食相比对上消化道肿瘤切除术后受试者的影响,采用二分法或连续方法,随机或固定影响模型。
结果:家庭肠内营养支持的生活质量显着提高(MD,2.08;95%CI,1.50-2.67,p<0.001),更好的体重变化(MD,1.87;95%CI,1.31-2.43,p<0.001),高白蛋白(MD,1.27;95%CI,0.72-1.82,p<0.001),和更高的前白蛋白(MD,30.79;95%CI,7.29-54.29,p=0.01),与正常口服饮食的上消化道肿瘤切除术对象相比。然而,家庭肠内营养支持对血红蛋白没有显著影响(MD,4.64;95%CI,-4.17至13.46,p=0.30),和并发症(或,1.03;95%CI,0.76-1.40,p=0.83)与正常口服饮食的上消化道肿瘤切除术对象比拟。
结论:家庭肠内营养支持具有更高的生活质量,更好的体重变化,高白蛋白,和更高的前白蛋白,与正常口服饮食相比,对上消化道肿瘤切除术受试者的血红蛋白和并发症没有显著影响。需要进一步的研究。
BACKGROUND: We performed a meta-analysis to evaluate the influence of a home enteral nutritional support compared with a normal oral diet in postoperative subjects with upper gastrointestinal cancer resection.
METHODS: A systematic literature search up to December 2021 was done and 23 studies included 3,010 subjects with upper gastrointestinal cancer resection at the start of the study; 1,556 of them were given home enteral nutritional support and 1,454 were normal oral diet. We calculated the odds ratio (OR) and mean difference (MD) with 95% CIs to evaluate the influence of home enteral nutritional support compared with a normal oral diet in postoperative subjects with upper gastrointestinal cancer resection by the dichotomous or continuous methods with a random or fixed-influence model.
RESULTS: Home enteral nutritional support had significantly higher quality of life (MD, 2.08; 95% CI, 1.50-2.67, p < 0.001), better body weight change (MD, 1.87; 95% CI, 1.31-2.43, p < 0.001), higher albumin (MD, 1.27; 95% CI, 0.72-1.82, p < 0.001), and higher pre-albumin (MD, 30.79; 95% CI, 7.29-54.29, p = 0.01) compared to the normal oral diet in subjects with upper gastrointestinal cancer resection. However, home enteral nutritional support had no significant impact on the hemoglobin (MD, 4.64; 95% CI, -4.17 to 13.46, p = 0.30), and complications (OR, 1.03; 95% CI, 0.76-1.40, p = 0.83) compared to the normal oral diet in subjects with upper gastrointestinal cancer resection.
CONCLUSIONS: Home enteral nutritional support had a significantly higher quality of life, better body weight change, higher albumin, and higher pre-albumin, and had no significant impact on the hemoglobin and complications compared to the normal oral diet in subjects with upper gastrointestinal cancer resection. Further studies are required.