添加鱼油脂肪乳的肠外营养对胃肠道恶性肿瘤患者术后临床结局影响的Meta分析

Effect of Fish Oil-Supplemented Parenteral Nutrition on Clinical Outcomes of Surgical Patients with Gastrointestinal Cancer:a Meta-analysis

目的:系统评价添加鱼油脂肪乳的肠外营养对胃肠道恶性肿瘤患者术后临床结局的影响。方法:检索1996年1月至2016年12月The Cochrane Library、Pub Med、EMBASE、中国知网(CNKI)、万方数据库等中英文数据库中相关的文献,同时进行手工检索和参考文献回溯。利用Jadad量表对文献进行方法学质量评价,筛选出高质量随机对照研究。采用Rev Man 5.3软件进行统计学分析。结果:共纳入8个随机对照研究,合计588例患者。Meta分析结果显示:添加鱼油脂肪乳的肠外营养能降低胃肠道恶性肿瘤患者术后感染并发症发生率[OR=0.44,95%CI(0.24,0.81),P=0.008],缩短术后住院时间[MD=-1.88,95%CI(-2.42,-1.34),P<0.00001]和术后ICU入住时间[MD=-0.32,95%CI(-0.51,-0.13),P=0.0009]。结论:添加鱼油脂肪乳的肠外营养能显著降低胃肠道恶性肿瘤患者术后感染并发症的发生率,缩短术后住院时间和术后ICU入住时间,改善患者术后临床结局。

Objective： To evaluate the effect of fish oil-supplemented parenteral nutrition on clinical outcomes of surgical patients with gastrointestinal cancer. Methods： Literatures relating to the evaluation of clinical outcomes of surgical patients with gastrointestinal cancer were searched in databases including the Cochrane Library, PubMed, EMBASE, CNKI and Wanfang Database from January 1996 to December 2016. The methodological quality was assessed using Jadad scale and all high quality randomized controlled trials were included. Meta analysis were conducted using RevMan 5.3 software. Results： Totally 8 randomized controlled trials involving 588 patients were included. Meta-analysis showed that compared with controlled group,there was significant difference in terms of the complications of infection [OR=0.44, 95%CI （0.24, 0.81）, P=0.008], the length of hospital stay [MD=-l.88, 95%CI （-2.42, -1.34）, P〈0.00001] and the length of ICU stay [MD=-0.32, 95%CI （-0.51, -0.13）, P=0.0009]. Conclusion： For surgical patients with gastrointestinal cancer, fish oil-supplemented parenteral nutrition can reduce postoperative infectious complications, shorten the length of hospital stay and the length of ICU stay.