营养支持治疗对终末期恶性肿瘤患者临床结局影响的Meta分析

目的 评价营养支持治疗对终末期恶性肿瘤患者临床结局的影响，为改善终末期恶性肿瘤患者生存质量提供一定的指导。方法 检索1995年1月1日~2019年4月31日Cochrane Library、PubMed、Embase、中国知网、万方数据库、维普数据库中关于营养支持治疗对终末期恶性肿瘤患者影响的随机对照试验（RCT）文献，实验组为常规抗肿瘤治疗加营养支持，对照组为常规抗肿瘤治疗和普通膳食，采用RevMan5.3软件进行统计分析，比较两组血清白蛋白（ALB）、血清前白蛋白（PA）、营养风险、不良反应。结果 本研究共纳入5篇文献、500例患者，Meta分析结果显示:实验组ALB高于对照组，差异有统计学意义（WMD=8.29，95%CI:4.84~11.74，P＜0.05）；实验组PA高于对照组，差异有统计学意义（WMD=58.54，95%CI:38.98~78.10，P＜0.05）。对照组发生营养风险的可能性是实验组的2.75倍，差异有统计学意义（RR=2.75，95%CI:1.80~4.20，P＜0.05）；对照组发生不良反应的可能性是实验组的1.17倍，差异有统计学意义（RR=1.17，95%CI:1.02~1.34，P＜0.05）。结论 合理的营养支持能明显改善终末期恶性肿瘤患者ALB、PA和降低营养风险及不良反应的发生。

Meta-analysis of Effect of Nutritional Support Therapy on Clinical Outcome of Patients with Terminal-stage Malignant Tumor

Objective To evaluate the effect of nutritional support therapy on clinical outcomes in patients with end-stage malignant tumors, and to provide some guidance for improving the quality of life of patients with end-stage malignant tumors. Methods A randomized controlled trial (RCT) on the effects of nutritional support therapy on patients with end-stage malignancies from Cochrane Library, PubMed, Embase, CNKI, Wanfang Database, and VIP Database from January 1, 1995 to April 31, 2019. The literature, the experimental group for conventional anti-tumor treatment plus nutritional support, the control group for conventional anti-tumor treatment and common diet, using RevMan5.3 software for statistical analysis.Results A total of 5 articles and 500 patients were included in the study. Meta-analysis showed that serum albumin (ALB) was higher in the experimental group than in the control group (WMD=8.29, 95% CI: 4.84~11.74, P＜0.05); serum prealbumin (PA) in the experimental group was higher than the control group, the difference was statistically significant (WMD=58.54, 95% CI: 38.98~78.10, P＜0.05). The risk of nutritional risk in the control group was 2.75 times that of the experimental group,the difference was statistically significant (RR=2.75, 95% CI: 1.80~4.20, P＜0.05); the possibility of adverse reactions in the control group was experimental group 1.17 times, the difference was statistically significant (RR=1.17, 95% CI: 1.02~1.34, P＜0.05).Conclusion Rational nutritional support can significantly improve ALB, PA and reduce nutritional risk and adverse reactions in patients with end-stage malignant tumors.