Department of Surgery, Marienhospital Herne, Clinic of the Ruhr University Bochum, Germany.
Nutrition. 2013 May;29(5):724-9. doi: 10.1016/j.nut.2012.10.007. Epub 2013 Jan 22.
A recent study suggested that the anti-inflammatory effect of immunonutrition starts after only two d. We therefore investigated the effect of an immunoenriched oral diet administered for three d preoperatively.
In this prospective, randomized, double-blind, placebo-controlled study, well-nourished patients (Nutrition Risk Screening 2002 <3) with gastrointestinal cancer who were scheduled for major elective abdominal cancer surgery were randomly assigned to either 750 mL of an immunoenriched formula (IEF group) or 750 mL of an isocaloric, isonitrogenous placebo diet (Con group) for 3 consecutive d preoperatively.
A total of 108 patients (IEF group: n = 55; Con group: n = 53) were randomized. The two groups were comparable for all baseline and surgical characteristics. The overall mortality was 2.8% and not significantly different between the two groups (IEF group: 3.6% vs. Con group: 1.9%, P = 1.00). Intention-to-treat analysis showed no difference for the incidence of postoperative overall (IEF group: 29% vs. Con group: 30%; P = 1.00) and infectious (IEF group: 15% vs. Con group: 17%; P = 0.79) complications. Length of hospital stay was 12 ± 4.9 d in the IEF group and 11.6 ± 5.3 d in the Con group (P = 0.68).
Preoperative oral supplementation with an immunoenriched diet for 3 d preoperatively did not improve postoperative outcome compared with the placebo in well-nourished patients with elective gastrointestinal cancer surgery.
最近的一项研究表明，免疫营养的抗炎作用仅在两天后就开始显现。因此，我们研究了术前三天给予免疫增强型口服饮食的影响。
这是一项前瞻性、随机、双盲、安慰剂对照研究，纳入了计划接受择期腹部大手术的胃肠道癌症且营养状况良好（营养风险筛查 2002＜3）的患者，将其随机分为免疫增强配方组（IEF 组，n=55）和等热量、等氮等渗安慰剂组（Con 组，n=53），两组患者均在术前连续 3 天接受 750 mL 相应处理。
共纳入 108 例患者（IEF 组：n=55；Con 组：n=53）。两组患者的所有基线和手术特征均具有可比性。总的死亡率为 2.8%，两组间无显著差异（IEF 组：3.6% vs. Con 组：1.9%，P=1.00）。意向治疗分析显示，两组患者术后总（IEF 组：29% vs. Con 组：30%；P=1.00）和感染（IEF 组：15% vs. Con 组：17%；P=0.79）并发症的发生率也无差异。IEF 组患者的住院时间为 12±4.9 d，Con 组为 11.6±5.3 d（P=0.68）。
与安慰剂相比，营养状况良好的择期胃肠道癌症手术患者术前 3 天给予免疫增强型饮食口服补充并未改善术后结局。
