肠内营养支持对食管癌术后患者生活质量影响的Meta分析

A meta-analysis of the effect of enteral nutrition support on the quality of life of patients with esophageal cancer after surgery

目的系统评价肠内营养(EN)对食管癌(EC)患者术后生活质量的影响。方法检索数据库中国知网、万方、维普网、Pubmed、Cochrane library、Embase、Web of science,检索时限从建库至2023年5月31日。检索EN及肠外营养(PN)对EC患者术后生活质量影响的随机对照试验(RCT),两名研究者按照纳入排除标准进行筛选文献、提取数据,使用R语言3.6.1软件进行Meta分析。结果共纳入5篇文献,共有427例EC患者。Meta分析结果显示,EN组患者角色功能评分〔WMD=13.86,95%CI(8.53,19.20)〕、社会功能评分〔WMD=12.10,95%CI(8.28,15.92)〕、总体健康状况评分均高于PN组〔WMD=12.51,95%CI(10.17,14.30)〕。EN组患者恶心呕吐〔WMD=-9.03,95%CI(-10.38,-7.68)〕、失眠〔WMD=-14.07,95%CI(-16.44,-11.70)〕、食欲下降〔WMD=-9.46,95%CI(-10.99,-7.93)〕、便秘症状评分〔WMD=-9.76,95%CI(-11.71,-7.82)〕及经济困难〔WMD=-8.57,95%CI(-14.62,-2.82)〕均低于PN组。结论EN可以在一定程度上改善EC患者术后的生活质量。仍需开展更多高质量、大样本的RCT来验证EN的近期和远期效果。

Objective To systematically evaluate the effect of enteral nutrition(EN)on postoperative quality of life in patients with esophageal cancer(EC).Methods The search databases CNKI,Wanfang,Vip,PubMed,Cochrane Library,Embase and Web of Science were searched from the establishment of the database to May 31,2023.Randomized controlled trials(RCTs)of the effects of EN and parenteral nutrition(PN)on postoperative quality of life in patients with EC weresearched.Two investigators screened the literature according to inclusion and exclusion criteria,extracted data.R language 3.6.1 software was used to conduct meta-analysis.Results A total of 5 literatures with 427 EC patients were included.The result of meta-analysis showed that patients in the EN group had higher scores of role function〔WMD=13.86,95%CI(8.53,19.20)〕,social function〔WMD=12.10,95%CI(8.28,15.92)〕and overall health status〔WMD=12.51,95%CI(10.17,14.30)〕than those of the PN group.Moreover,patients in the EN group had lower scores of nausea and vomiting,insomnia,loss of appetite,constipation symptoms[WMD=-9.76,95%CI(-11.71,-7.82)]and economic hardship〔WMD=-8.57,95%CI(-14.62,-2.82)〕than those of the PN group.Conclusions EN can improve the quality of life of EC patients after surgery to some extent.More high quality,large sample RCTs are still needed to validate the immediate and long term effects of EN.