早期营养是安全的,并且不会增加上部胃肠道出血后的并发症 - - 随机对照试验的系统审查和元分析
Mahmoud Obeidat1,2, Brigitta Teutsch1,2, Diana-Elena Floria1,3
1Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Hungary.
上部胃肠道出血 (UGIB) 后的早期营养 (EN) 是安全的,并减少了住院时间. 这次元分析没有发现死亡或再出血的风险增加,支持UGIB患者的及时营养干预.
科学领域:
- 胃肠病学 胃肠病学
- 临床营养学 临床营养学
- 基于证据的医学基于证据的医学.
背景情况:
- 推迟营养是上胃肠道出血 (UGIB) 后的常见做法,尽管证据有限.
- 之前的试验表明,在患有UGIB的患者中,早期营养 (EN) 有好处.
- 在UGIB.中缺乏对EN结果与延迟营养 (DN) 的全面元分析.
研究的目的:
- 评估早期营养 (EN) 与UGIB后延迟营养 (DN) 的安全性和有效性.
- 评估EN对死亡率,再出血率和住院时间的影响.
- 为UGIB患者提供基于证据的营养管理建议.
主要方法:
- 通过全面的数据库搜索 (PubMed,Embase,CENTRAL,Scopus,Web of Science) 识别的随机对照试验 (RCT) 的元分析.
- 主要结局包括早期和晚期死亡率和再出血.
- 其次结果是住院时间的长度. 用于聚合分析的随机效应模型.
主要成果:
- 包括10个RCT,包括1051名患者.
- 早期死亡率没有显著差异 (RR 1.20,CI 0.85-1.71).
- 在EN组中,晚期死亡率降低 (RR 0.61,CI 0.35-1.06).
- 早期或晚期再出血率没有显著差异.
- EN显著减少了住院时间 (MD -1.22天,CI: -2.43至 -0.01).
结论:
- 早期营养 (24小时内) 是上胃肠道出血后患者的安全干预措施.
- 艾滋病并不会增加死亡或再出血的风险.
- 早期营养可以显著减少住院时间.
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