腹部大手术后的蛋白质节省疗法：缺乏临床效果。蛋白质节省疗法研究小组。
Protein-sparing therapy after major abdominal surgery: lack of clinical effects. Protein-Sparing Therapy Study Group.
作者信息
Doglietto G B, Gallitelli L, Pacelli F, Bellantone R, Malerba M, Sgadari A, Crucitti F
机构信息
Istituto di Clinica Chirurgica, UCSC, Roma, Italy.
出版信息
Ann Surg. 1996 Apr;223(4):357-62. doi: 10.1097/00000658-199604000-00003.
OBJECTIVE
A prospective multicenter randomized trial was designed to evaluate the clinical efficacy of postoperative protein-sparing therapy.
SUMMARY BACKGROUND DATA
The metabolic effect of postoperative protein-sparing therapy has been shown by several studies, but the clinical utility of this treatment has not been investigated by large prospective trials.
METHODS
Six hundred seventy-eight patients undergoing major elective abdominal surgery were randomly assigned to receive either protein-sparing therapy after surgery (protein-sparing therapy group) or conventional therapy (control group). The patients were monitored for postoperative complications and mortality.
RESULTS
The rate of major postoperative complications was similar in both groups (protein-sparing therapy group, 19.5%; control group, 20.9%; p=0.66) as were the overall postoperative mortality rates (4.7% and 3.5%, respectively; p=0.43).
CONCLUSIONS
The present study indicates that routine protein-sparing therapy for patients normonourished or mildly malnourished undergoing major abdominal surgery is not clinically justified.
目的
设计一项前瞻性多中心随机试验，以评估术后蛋白质节省疗法的临床疗效。
总结背景数据
多项研究已表明术后蛋白质节省疗法的代谢效应，但该治疗方法的临床实用性尚未通过大型前瞻性试验进行研究。
方法
678例接受择期腹部大手术的患者被随机分配，术后分别接受蛋白质节省疗法（蛋白质节省疗法组）或传统疗法（对照组）。对患者的术后并发症和死亡率进行监测。
结果
两组术后主要并发症发生率相似（蛋白质节省疗法组为19.5%；对照组为20.9%；p=0.66），术后总体死亡率也相似（分别为4.7%和3.5%；p=0.43）。
结论
本研究表明，对于接受腹部大手术的营养正常或轻度营养不良患者，常规的蛋白质节省疗法在临床上并无依据。
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