Wanden-Berghe C, Sanz-Valero J, García de Lorenzo A, Martín-Peña G, Cervera M, Luengo L, Martín-Folgueras T, Laborda L
Universidad CEU Cardenal Herrera, Elche, España.
Nutr Hosp. 2012 Mar-Apr;27(2):409-18. doi: 10.1590/S0212-16112012000200010.
Malnutrition in hospitals is of great concern in patients with cancer. This malnutrition in cancer leads to higher risk of complications, and worse response to treatments and outcomes. Parenteral nutrition (PN) in cancer is controversial due to the heterogeneous results found in scientific literature. This is the reason why the evaluation of adverse events of PN, its incidence and severity, is crucial when prescribing PN in cancer patients. This evaluation of adverse events of PN is the aim of the present systematic review of the randomized clinical trials (RCT) written in any language found in several databases. From the 74 articles found in our search, only 13 RCT (18 different types of cancer) met the criteria to be selected for the systematic review. These RCT included 669 patients receiving central PN in whom 225 adverse events (33.63%) of PN were described, and 92 patients with peripheral PN, with 54 adverse events (58.70%). There were no adverse events in a control group of 47 patients receiving parenteral fluids. We conclude that scientific literature is very heterogeneous and evaluate complications of parenteral nutrition only as a secondary aim. We think necessary that further research do define complications of parenteral nutrition homogeneously and study them as a main objective.
医院中癌症患者的营养不良问题备受关注。癌症患者的这种营养不良会导致更高的并发症风险，以及对治疗和预后更差的反应。由于科学文献中发现的结果存在异质性，癌症患者的肠外营养（PN）存在争议。这就是为什么在给癌症患者开PN处方时，评估PN的不良事件、其发生率和严重程度至关重要。对PN不良事件的这种评估是本次对在多个数据库中找到的任何语言撰写的随机临床试验（RCT）进行系统评价的目的。在我们检索到的74篇文章中，只有13项RCT（18种不同类型的癌症）符合纳入系统评价的标准。这些RCT包括669例接受中心PN的患者，其中描述了225例PN不良事件（33.63%），以及92例接受外周PN的患者，有54例不良事件（58.70%）。在47例接受肠外补液的对照组患者中未出现不良事件。我们得出结论，科学文献非常异质性，并且仅将肠外营养并发症评估作为次要目标。我们认为有必要进一步研究，以统一界定肠外营养并发症，并将其作为主要目标进行研究。
