本文選題：結(jié)直腸癌 + 結(jié)直腸外科手術(shù)　； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的:利用Meta分析的方法,比較早期經(jīng)口進食(EOF)與傳統(tǒng)經(jīng)口進食(TOF)對結(jié)直腸癌術(shù)后患者的影響。方法:計算機檢索PubMed、SCI、Ovid、The Cochrane Library、CNKI、CBM、VIP及萬方數(shù)據(jù)庫,全面收集比較EOF和TOF兩種不同干預(yù)措施對結(jié)直腸癌術(shù)后患者臨床結(jié)局影響的隨機對照試驗(RCT),檢索各數(shù)據(jù)庫自建庫以來至2016年6月1日收錄的文獻,2名研究者根據(jù)納入排除標準進行篩選,提取資料,之后RevMan5.2處理數(shù)據(jù)。結(jié)果:共得到14篇RCT,1807名患者。EOF組患者術(shù)后首次排氣時間[MD=-16.11h,95%CI(-18.27~-13.94 h),P0.00001],術(shù)后住院時間[MD=-1.92 d,95%CI(-2.83~-1.01 d),P0.0001],住院花費[MD=-0.58萬元,95%CI(-0.71~-0.46萬元),P0.00001]均少于TOF組。EOF組患者有更低的總并發(fā)癥發(fā)生率[OR=0.68,95%CI(0.48~0.95),P=0.03],其中肺部感染[OR=0.27,95%CI(0.13~0.53),P=0.0002],咽部炎癥[OR=0.06,95%CI(0.04~0.11),P0.00001]的發(fā)生率均明顯低于TOF組,胃管再置[OR=2.34,95%CI(1.08~5.07),P=0.03]的發(fā)生率高于TOF組,兩組間吻合口瘺、惡心嘔吐、腹脹、腹瀉、切口感染等發(fā)生均無統(tǒng)計學差異。從免疫水平來看,兩組患者術(shù)后7天IgM無統(tǒng)計差異,但IgA[MD=0.3,95%CI(0.12~0.48),P=0.001],IgG[MD=2.13,95%CI(0.82~3.44),P=0.001],CD4+[MD=3.80,95%CI(2.55~5.04),P0.00001],CD4+/CD8+[MD=0.22,95%CI(0.04~0.41),P=0.02]均高于TOF組。炎性指標方面,患者術(shù)后CRP下降較快[MD=-30.10,95%CI(-48.07~-12.13),P=0.001],而IL-6差異無統(tǒng)計學意義。同時術(shù)后5天以上EOF組患者有更高的血清白蛋白水平[MD=3.27,95%CI(2.48~4.07),P0.00001]。結(jié)論:EOF可促進患者排氣排糞,縮短術(shù)后住院時間,降低治療費用,減少相關(guān)并發(fā)癥的發(fā)生,并可能降低術(shù)后炎性反應(yīng)及維護患者免疫功能,值得臨床推廣。
[Abstract]:Objective: to compare the effects of early oral feeding (EOF) and traditional oral feeding (TOF) on postoperative colorectal cancer patients by Meta analysis.Methods: a computer-based search was conducted for the Cochrane Library CNKICIM VIP and the Wanfang database.A randomized controlled trial was conducted to compare the effects of EOF and TOF interventions on the clinical outcomes of patients with colorectal cancer after surgery. Two documents collected from various databases up to June 1, 2016 were retrieved according to the results of the study.Inclusion of exclusion criteria for screening,Extract the data and then RevMan5.2 processes the data.緇撴灉:鍏卞緱鍒，

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