Nikniaz Zeinab, Somi Mohammad Hossein, Nagashi Shahnaz, Nikniaz Leila
a Liver and Gastrointestinal Disease Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.
b Tabriz Health Services Management Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.
Nutr Cancer. 2017 Jul;69(5):693-701. doi: 10.1080/01635581.2017.1324996. Epub 2017 Jun 1.
The present systematic review and meta-analysis study evaluated the impact of early enteral nutrition (EN) on postoperative nutritional and immunological outcomes of gastric cancer (GC) patients.
The databases of PubMed, Embase, Springer, and Cochrane library were searched till September 2016 to identify studies which evaluated the effects of EN compared with parenteral nutrition (PN) on postoperative immunological and nutritional status and hospitalization time in GC patients. Mean difference (MD) or standard mean difference (SMD) was calculated and I-square statistic test was used for heterogeneity analysis.
The present systematic review and meta-analysis have consisted of seven trials, containing 835 GC patients. According to the result of meta-analysis, compared with PN, EN significantly resulted in more increase in the level of albumin [MD = 2.07 (0.49, 3.64)], prealbumin [MD = 9.41 (049, 33.55)], weight [MD = 1.52 (0.32, 2.72)], CD3+ [SMD = 1.96 (1.50, 2.43)], CD4+ [SMD = 2.45 (1.97, 2.93)], natural killers [MD = 5.80 (3.75, 7.85)], and also a decrease in the hospitalization time [MD=-2.39 (-2.74, -2.03)].
The results demonstrated that early administration of EN is more effective in improving postsurgical nutrition status and immune index in GC patients. So, based on these results, postoperative early administration of EN is recommended for GC patients where possible.
本系统评价和荟萃分析研究评估了早期肠内营养（EN）对胃癌（GC）患者术后营养和免疫结局的影响。
检索截至2016年9月的PubMed、Embase、Springer和Cochrane图书馆数据库，以确定评估EN与肠外营养（PN）相比对GC患者术后免疫和营养状况及住院时间影响的研究。计算平均差（MD）或标准化平均差（SMD），并使用I²统计检验进行异质性分析。
本系统评价和荟萃分析纳入了7项试验，共835例GC患者。根据荟萃分析结果，与PN相比，EN显著使白蛋白水平[MD = 2.07（0.49，3.64）]、前白蛋白水平[MD = 9.41（0.49，33.55）]、体重[MD = 1.52（0.32，2.72）]、CD3⁺[SMD = 1.96（1.50，2.43）]、CD4⁺[SMD = 2.45（1.97，2.93）]、自然杀伤细胞水平[MD = 5.80（3.75，7.85）]升高更多，同时住院时间缩短[MD = -2.39（-2.74，-2.03）]。
结果表明，早期给予EN对改善GC患者术后营养状况和免疫指标更有效。因此，基于这些结果，建议在可能的情况下对GC患者术后早期给予EN。
