胃癌患者术后早期经口进食的安全性与可行性Meta分析

Safety and feasibility of early oral feeding after gastrectomy： a meta-analysis

目的系统评价胃癌患者术后早期经口进食的安全性与可行性。方法检索Embase、PubMed、Journals@Ovid、Springerlink、Google Scholar、万方和中国知网2012年10月之前比较胃癌患者术后早期经口进食和术后禁食的研究，进行文献质量评价，对符合标准的文献提取相关效应指标进行Meta分析。结果5项随机对照研究和4项非随机对照研究共计778例病例纳入研究，其中早期经口进食组381例，术后禁食组397例。两组患者术后并发症发生率（RR=0．88，95％CI：0．68～1．16）和耐受程度（RR=1．01，95％CI：0．96～1．06）的差异均无统计学意义；但早期经口进食组肠道功能恢复时间（MD=-0．86，95％C1：-1．20～-0．51）和住院时间（MD=-2．40，95％CI：-3．33～-1．47）较禁食组明显缩短。结论胃癌患者术后早期经口进食安全、可行，而且可以促进患者术后肠道功能的恢复并并缩短住院时间。

Objective To systematically evaluate the safety and feasibility of early oral feeding after gastric cancer surgery. Methods Available literatures of Embase, PubMed, Journals@Ovid, Web of Science, Springerlink, Google Scholar, Wanfang, and CNKI published before October 2012 were searched. Inclusion criteria and quality assessment were performed. Results Nine studies including 778 patients undergoing gastrectomy were enrolled. Among them, 381 started oral intake before the recovery of bowel function （early oral feeding group）, and 397 received traditional feeding. Differences in overall complication（RR=0.88, 95%CI：0.68-1.16） and tolerance （RR=1.01, 95%CI：0.96-1.06） between the two groups were not statistically significant. Patients the in early oral feeding group had faster bowel function recovery （MD=-0.86, 95%CI：-1.20--0.51） and shorter hospital stay（MD=-2.40, 95%C1：-3.33--1.47）. Conclusion Early oral feeding after gastrectomy is safe and feasible, and associated with faster recovery of bowel function and earlier discharge from hospital.