在接受心脏手术的儿童中进行基于营养的术前干预 - - 一项系统性审查和元分析
Agata Stróżyk1, Piotr Halicki2, Maciej Kołodziej1
1Department of Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland.
Nutrients
|February 13, 2026
概括
在儿科心脏外科手术中进行手术前营养干预似乎是安全的,并可能改善结果. 然而,证据的确定性非常低,强调需要对营养方案进行更严格的研究.
科学领域:
- 儿科手术 儿科手术
- 营养科学 营养科学
- 临界护理医学 临界护理医学
背景情况:
- 儿童心脏外科手术需要最佳的患者条件以改善结果.
- 手术前的营养状况显著影响了儿科手术患者的康复和并发症率.
- 在这个人群中,手术前营养干预措施的疗效证据有限.
研究的目的:
- 系统地审查手术前基于营养的干预措施的有效性和安全性.
- 评估这些干预措施对接受心脏手术的儿童手术前,手术后和手术后结果的影响.
- 用GRADE方法评估证据的确定性.
主要方法:
- 在CENTRAL,MEDLINE和EMBASE数据库中进行系统搜索,截至2025年7月.
- 包括介入和观察性研究,比较儿童心脏手术患者的营养干预与对照组.
- 主要结局:术后在重症监护室 (ICU) 停留的时间.
主要成果:
- 19项研究 (8项RCT,1项非随机试验,10项观察性) 评估了脂肪酸和维生素D等各种干预措施.
- 两个RCT显示了更短的ICU和医院住院时间,以及延长的手术前营养支持.
- 观察数据表明,住院时间缩短,肠道食速度加快,但在ICU住院时间上没有显著差异.
结论:
- 在儿科心脏手术中进行手术前营养干预是安全的,具有潜在的临床益处.
- 支持这些益处的证据的确定性非常低.
- 显著的异质性需要精心设计的试验和标准化的手术前营养方案.
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