EARLY ENTERAL FEEDING, COMPARED WITH PARENTERAL, REDUCES POSTOPERATIVE SEPTIC COMPLICATIONS - THE RESULTS OF A METAANALYSIS
EARLY ENTERAL FEEDING, COMPARED WITH PARENTERAL, REDUCES POSTOPERATIVE SEPTIC COMPLICATIONS - THE RESULTS OF A METAANALYSIS
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DOI：
10.1097/00000658-199208000-00008
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发表时间：
1992-08-01
影响因子：
9
通讯作者：
MOORE, EE
中科院分区：
文献类型：
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作者：
MOORE, FA;FELICIANO, DV;MOORE, EE
这项由两部分组成的荟萃分析结合了8项前瞻性随机试验的数据，这些试验旨在比较高危手术患者早期肠内（TEN）和肠外（TPN）营养的营养疗效。合并数据提供了足够的患者数量（TEN，n = 118; TPN，n = 112），以充分说明底物输送途径是否影响脓毒性并发症的发生率。I期（排除脱落）荟萃分析证实了各研究中心的数据同质性，TEN组和TPN组相当，并且TEN患者发生脓毒性并发症的人数显著较少（TEN，18%; TPN，35%; p = 0.01）。II期荟萃分析，一项意向治疗分析（包括脱落），证实TEN患者较少发生脓毒性并发症。按患者类型进一步细分显示，所有创伤和钝性创伤亚组在肠内喂养时脓毒性并发症的减少最显著。总之，该荟萃分析证实了高风险手术患者术后早期TEN的可行性，并且与接受TPN的患者相比，这些患者的脓毒症发病率降低。
This two-part meta-analysis combined data from eight prospective randomized trials designed to compare the nutritional efficacy of early enteral (TEN) and parenteral (TPN) nutrition in high-risk surgical patients. The combined data gave sufficient patient numbers (TEN, n = 118; TPN, n = 112) to adequately address whether route of substrate delivery affected septic complication incidence. Phase I (dropouts excluded) meta-analysis confirmed data homogeneity across study sites, that TEN and TPN groups were comparable, and that significantly fewer TEN patients experienced septic complications (TEN, 18%; TPN, 35%; p = 0.01). Phase II meta-analysis, an intent-to-treat analysis (dropouts included), confirmed that fewer TEN patients developed septic complications. Further breakdown by patient type showed that all trauma and blunt trauma subgroups had the most significant reduction in septic complications when fed enterally. In conclusion, this meta-analysis attests to the feasibility of early postoperative TEN in high-risk surgical patients and that these patients have reduced septic morbidity rates compared with those administered TPN.