甲状腺切除患者术前口服碳水化合物效果的meta分析

刘洁; 韩鹏; 隋芳; 闫金凤; 张玺平; 侯唤; 毕莹

doi:10.16766/j.cnki.issn.1674-4152.003854

甲状腺切除患者术前口服碳水化合物效果的meta分析

doi: 10.16766/j.cnki.issn.1674-4152.003854

西安交通大学第一附属医院耳鼻咽喉头颈外科，陕西西安 710061

基金项目:

陕西省自然科学基础研究基金项目 2022JQ-834

详细信息

通讯作者:
闫金凤，E-mail：liujie18435116520@163.com

中图分类号: R653
计量
- 文章访问数: 28
- HTML全文浏览量: 19
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-01-22
- 网络出版日期: 2025-02-13

Meta-analysis of preoperative oral carbohydrate effects in patients with thyroidectomy

Department of Otolaryngology Head and Neck surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi ' an, Shaanxi 710061, China

摘要

摘要: 目的通过meta分析评价国内外有关术前口服碳水化合物对甲状腺切除患者围手术期的有效性及安全性，以指导患者术前正确口服碳水化合物。方法利用知网、维普、万方、PubMed、EMbase、Web of Science、Wiley Online Library等中英文数据库检索相关的随机对照试验，检索时间为建库至2021年3月21日，根据纳入排除标准由2名研究者独立进行文献筛选及资料提取，采用RevMan软件(5.3版)对文献进行质量评价及meta分析。结果 16篇随机对照试验纳入研究，共计1 793例患者。试验组为术前口服碳水化合物，对照组为术前常规禁饮食，结果显示：术前口干口渴指标[95% CI(-2.39~-0.47), P=0.003]，术后恶心呕吐指标[95% CI(0.41~0.80), P=0.001]，胰岛素抵抗指数指标[95% CI(-2.73~-0.69), P=0.001]，术后首次下床活动时间指标[95% CI(-1.56~-0.87), P＜0.01], 术后首次进食时间指标[95% CI(-1.07~-0.13), P=0.010], 住院时间指标[95% CI(-2.67~-1.55), P＜0.01]，术后并发症数指标[95% CI(0.08~0.32), P＜0.01], 均为试验组优于对照组(P＜0.05)。结论与常规护理相比，术前口服碳水化合物对甲状腺切除患者围手术期的影响是安全且有益的，具有良好的临床应用价值。
- 甲状腺切除患者 /
- 术前口服碳水化合物 /
- Meta分析
Abstract: Objective To evaluate the efficacy and safety of preoperative oral carbohydrate in patients with thyroidectomy during the perioperative period by meta-analysis, and to guide the clinical implementation. Methods CNKI, VIP, Wanfang, PubMed, Embase, Web of Science, Wiley Online Library, and other Chinese and English databases were used to search related RCT. The retrieval period was from the establishment of the database to March 21, 2021. According to the inclusion and exclusion criteria, literature screening and data extraction were conducted independently by two researchers. RevMan software (version 5.3) was used for literature quality evaluation and meta-analysis. Results Sixteen randomized controlled trials involving 1 793 patients were included in the study. The experimental group was given oral carbohydrate before surgery, while the control group was given a conventional diet before surgery, The results showed as follows: preoperative indexes of dry mouth and thirst [95% CI (-2.39, -0.47), P=0.003], postoperative indexes of nausea and vomiting [95% CI (0.41, 0.80), P=0.001], indexes of insulin resistance [95% CI (-2.73, -0.69), P=0.001], the first time to get out of bed after surgery [95% CI (-1.56, -0.87), P < 0.01], the first time to eat after surgery [95% CI (-1.07, -0.13), P=0.010], the number of hospitalization days [95% CI (-2.67, -1.55), P < 0.01], and the number of postoperative complications [95% CI (0.08, 0.32), P < 0.01], indicating that the experimental group was better than the control group (P < 0.05). Conclusion Compared with conventional care, preoperative oral carbohydrate is safe and beneficial in the perioperative period of patients with thyroidectomy, and has good clinical application value.
- Patients with thyroidectomy /
- Preoperative oral carbohydrate /
- Meta analysis

HTML全文

图 1 术前口服CHO对患者术前口干口渴的影响

Figure 1. Influence of preoperative oral CHO on dry mouth and thirst in patients

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图 2 术前口服CHO对患者术后恶心呕吐的影响

Figure 2. Effect of oral CHO on postoperative nausea and vomiting

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表 1 纳入文献的基本特征

Table 1. The basic characteristics of literature

纳入研究	国家	样本例数		疾病类型	干预措施		结局指标
纳入研究	国家	对照组	观察组	疾病类型	对照组	观察组	结局指标
叶奎2012^[8]	中国	57	55	ab	常规禁饮食	术前2 h 5% GS 200 mL	①⑥⑧⑩⑪⑬
柯丹纯2017^[9]	中国	90	90	a	常规禁饮食	术前晚饮5% GS 800 mL, 术前2~3 h饮5% GS 400 mL	②③④⑥⑧⑪⑬⑭
吕卓辰2017^[10]	中国	33	29	ab	常规禁饮食	术前2 h CHO 700 mL	①⑧⑬⑭
周学萍2019^[11]	中国	46	46	b	常规禁饮食	术前2~3 h 5% GS 300 mL	④⑥⑧⑭
陈丽君2020^[12]	中国	40	40	a	常规禁饮食	术前晚饮5% GS 800 mL, 术前2~3 h 5% GS 400 mL	②③④⑥
何永芬2020^[13]	中国	50	50	b	常规禁饮食	术前2 h CHO 300 mL	①④⑦⑧
王轶鹤2020^[14]	中国	45	45	b	常规禁饮食	术前4 h 10% GS 400 mL	④⑥⑧⑩⑬
柯丹纯2017^[15]	中国	80	80	a	常规禁饮食	术前晚饮5% GS 800 mL, 术前2~3 h饮5% GS 400 mL	②③④⑥⑧⑨
吴瑞云2020^[16]	中国	30	30	ab	常规禁饮食	术前晚5% GS 1 000 mL分次口服	①⑤
邢唯杰2007^[17]	中国	35	40	a	常规禁饮食	术前2 h CHO少许	①⑤⑥⑦⑮
朱赫2016^[18]	中国	27	27	a	常规禁饮食	术前2 h CHO 200 mL	①⑤⑭
董丽明2019^[19]	中国	76	68	b	常规禁饮食	术前晚饮CHO 800 mL, 术前2~3 h饮CHO 400 mL	①⑥⑩⑪⑬
DOO A R 2018^[20]	韩国	25	25	ab	常规禁饮食	术前2~3 h饮CHO 400 mL	①⑤⑦⑫
LAUWICK S M 2009^[21]	比利时	100	100	ab	常规禁饮食	术前2 h饮CHO 400 mL	①③⑤⑦⑫⑬⑭
ÇAKAR E 2017^[22]	土耳其	30	30	ab	常规禁饮食	术前晚饮CHO 800 mL, 术前2~3 h饮CHO 400 mL	⑤⑦⑫⑭⑮
ITOU K 2012^[23]	日本	139	135	ab	常规禁饮食	术前2 h饮用500 mL CHO	①⑦
注：a为甲状腺良性肿瘤，b为甲状腺恶性肿瘤；GS为葡萄糖(grape sugar)，CHO为碳水化合物(carbohydrate)；①恶心呕吐，②胰岛素抵抗指数，③首次进食时间，④首次下床活动时间，⑤术前口渴饥饿，⑥住院时间，⑦焦虑，⑧并发症，⑨满意度，⑩术中出血量，⑪住院费用，⑫疲劳，⑬手术间，⑭疼痛，⑮寒冷。

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