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在成年人胰腺切除术后的术后营养支持
Rachel H Robertson1, Kylie Russell2,3, Vanessa Jordan4
1Department of General Surgery, Waikato Hospital, Te Whatu Ora Waikato, Hamilton, New Zealand.
The Cochrane database of systematic reviews
|March 14, 2025
概括
在胰腺二管切除术后,术后的营养支持,如凝肠切除术的食,可能会减少与腹腔营养相比的住院时间. 然而,关于并发症的证据仍然不确定,强调需要进一步研究最佳养策略.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 手术瘤学手术瘤学
- 临床营养学 临床营养学
背景情况:
- 胰腺双管切除术 (Whipple手术) 是一种主要的手术,通常用于恶性瘤,需要仔细的营养管理.
- 营养不良是手术后的重要风险因素,因为手术的规模和潜在的并发症.
- 营养支持可以提供口服,肠道 (鼻管,结节管) 或亲肠道 (TPN).
研究的目的:
- 评估不同手术后营养支持策略对患者康复和胰腺管切除术后并发症的影响.
- 为了比较各种食路线和时间的有效性,以优化胰腺大手术后的结果.
主要方法:
- 系统综述和随机对照试验 (RCT) 的元分析,发表至2022年10月.
- 包括专注于术后营养干预的研究,比较路线或时间,而不是营养含量.
- 数据提取和偏差风险评估由两个审稿人独立进行,用于证据确定性的GRADE.
主要成果:
- 与肠道营养相比,肠道静脉切割食可能会减少住院时间 (中度确定性证据).
- 证据表明,在胰腺,延迟胃空化或血流之间没有显著的差异. 结肠切除术和腹腔营养 (低至非常低的确定性).
- 与TPN相比,鼻接养在结果上几乎没有差异,尽管TPN可能会略有改善鱼率 (低确定性证据).
结论:
- 与肠道营养相比,肠道结肠切除术的食似乎有利于减少胰腺除术后的住院时间.
- 目前关于不同营养策略对术后并发症的影响的证据确定性低至非常低.
- 需要高质量的研究和潜在的网络元分析,以澄清这种患者群体的最佳营养支持.
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