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围手术期免疫营养干预对妇科癌症患者的影响:一项系统评价。

Effect of perioperative immunonutrition intervention among gynecological cancer patients: A systematic review.

作者信息

Ho ChiouYi, Mohd Yusof Barakatun Nisak, Abdul Majid Hazreen, Daud Zulfitri Azuan Mat

机构信息

Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Seri Kembangan, Selangor, Malaysia; Department of Dietetics and Food Service, Institut Kanser Negara, Ministry of Health Malaysia, 4, Jalan P7, Presint 7, 62250 Wilayah Persekutuan Putrajaya, Malaysia.

Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Seri Kembangan, Selangor, Malaysia.

出版信息

Clin Nutr ESPEN. 2024 Dec;64:168-176. doi: 10.1016/j.clnesp.2024.09.022. Epub 2024 Oct 1.

Abstract

BACKGROUND

Gynecologic cancer (GC) patients often experience systemic inflammation, malnutrition, and compromised postoperative outcomes. This systematic review aims to comprehensively synthesize existing data regarding the impact of perioperative immunonutrition (IMN) intervention on GC patients.

METHODS

The databases of CENTRAL, EMBASE, Web of Science, and the Cochrane Library were used to conduct a literature search, supplemented by internet search engines and manual searches. Publications released between January 2009 and October 2023 was identified, reviewed, and data extracted.

RESULTS

The review encompasses six studies involving 712 patients, comprising two randomized controlled trials (RCTs), two prospective studies, and two retrospective cohort studies. Three studies prescribed IMN perioperatively; two pre-operatively and one post-operatively. Four out of six studies reported less post-operative infection and complications. Two studies reported shorter hospitalization using the IMN formula. One study reported a longer hospitalization with IMN supplementation. Overall survival showed no significant difference in the two studies. Four studies reported positive modulation of inflammatory markers and lymphocytes as outcomes, with IMN formulas.

DISCUSSION AND CONCLUSION

Perioperative IMN emerge as a promising intervention, demonstrating notable benefits included shortened hospitalization as well and positive modulation of inflammatory markers.

摘要

背景

妇科癌症(GC)患者常出现全身炎症、营养不良及术后预后不良。本系统评价旨在全面综合现有关于围手术期免疫营养(IMN)干预对GC患者影响的数据。

方法

使用CENTRAL、EMBASE、Web of Science和Cochrane图书馆数据库进行文献检索,并辅以互联网搜索引擎和手工检索。识别、审查并提取2009年1月至2023年10月期间发表的文献。

结果

该评价纳入六项研究,涉及712例患者,包括两项随机对照试验(RCT)、两项前瞻性研究和两项回顾性队列研究。六项研究中有三项在围手术期给予IMN;两项在术前给予,一项在术后给予。六项研究中有四项报告术后感染和并发症较少。两项研究报告使用IMN配方住院时间较短。一项研究报告补充IMN后住院时间延长。两项研究中总体生存率无显著差异。四项研究报告IMN配方可使炎症标志物和淋巴细胞得到正向调节。

讨论与结论

围手术期IMN是一种有前景的干预措施,显示出显著益处,包括缩短住院时间以及对炎症标志物的正向调节。

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