College of Nursing, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India.
Department of Anesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Eur J Pediatr Surg. 2023 Dec;33(6):454-462. doi: 10.1055/s-0043-1760837. Epub 2023 Feb 1.
Congenital anomalies, congenital malformations, or birth defects can be defined as any structural or functional anomalies that develop prenatally and could be identified before, at birth, or later in life. Approximately 6% of babies are born with a congenital anomaly, which results in 2.4 million newborn deaths worldwide. This systematic review and meta-analysis ascertained the quantitative studies published in PubMed, ClinicalKey, Embase, CINAHL, Cochrane Library, and Google Scholar. Two authors independently screened and extracted the data from the primary studies that analyzed the efficacy of early enteral nutrition (EEN) on the postoperative outcome. This systematic review and meta-analysis adopted Cochrane Collaboration guidelines and reported using the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement. The methodological quality of trials was assessed by Cochrane Collaboration's risk of bias tool. Six trials, representing 488 children, with age ranging from 10 days to 6.5 years, fulfilled the inclusion criteria. EEN has significantly shortened hospital stay, induced early fecal movement, and reduced postoperative wound infections in children with congenital gastrointestinal abnormalities undergoing gastrointestinal anastomosis compared with children who received late enteral nutrition. The review also found that the experimental group who received EEN had no significant impact on the anastomosis leakage, vomiting, and abdominal distension. EEN has some positive effects on postsurgery outcomes among children with congenital gastrointestinal anomalies undergoing gastrointestinal anastomosis.
先天性异常、先天性畸形或出生缺陷可定义为任何产前发育的结构或功能异常，可在出生前、出生时或出生后确定。大约有 6%的婴儿出生时带有先天性异常，这导致全世界有 240 万新生儿死亡。本系统评价和荟萃分析确定了在 PubMed、ClinicalKey、Embase、CINAHL、Cochrane Library 和 Google Scholar 上发表的定量研究。两名作者独立筛选并从分析早期肠内营养（EEN）对术后结果疗效的主要研究中提取数据。本系统评价和荟萃分析采用了 Cochrane 协作组的指南，并按照系统评价和荟萃分析的首选报告项目（PRISMA）声明进行报告。试验的方法学质量由 Cochrane 协作组的偏倚风险工具进行评估。有 6 项试验，涉及 488 名年龄在 10 天至 6.5 岁之间的儿童，符合纳入标准。与接受肠外营养的儿童相比，接受 EEN 的先天性胃肠道异常儿童在接受胃肠道吻合术时，住院时间明显缩短，粪便早期移动，术后伤口感染减少。该综述还发现，接受 EEN 的实验组在吻合口漏、呕吐和腹胀方面没有显著影响。EEN 对接受胃肠道吻合术的先天性胃肠道畸形儿童的术后结果有一些积极影响。
