文章：

口腔癌围手术期免疫增强营养干预的益处：一项系统综述与荟萃分析

Beneficial Outcomes of Immunoenhancing Nutritional Interventions in Perioperative Care for Oral Cancer: A Systematic Review and Meta-Analysis

原文发布日期：31 May 2025

DOI: 10.3390/cancers17111855

类型: Article

开放获取: 是

英文摘要：

Background: This systematic review aimed to evaluate the efficacy of immunoenhancing nutritional therapy compared to conventional nutritional care in reducing perioperative complications in adult patients undergoing surgery for oral cancer. Given the unclear role of immunonutrition in this specific surgical setting, we synthesized available randomized controlled trials to assess outcomes such as surgical site infections, wound healing complications, hospital stay, and adverse events. Methods: Patients who underwent planned oral cancer surgery were included. The intervention group received oral or enteral immunoenhancing nutritional agents preoperatively, postoperatively, or both, while the control group received standard care (intravenous fluids) and/or macromolecular nutritional supplements. PubMed, Cochrane CENTRAL, and Central Medical Journal were comprehensively searched for randomized controlled trials (RCTs); eight RCTs were included. The primary outcomes were mortality, suture/healing failure, surgical site infection (SSI), and hospital stay length, with evidence certainty assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Results: Although mortality estimation was not feasible, hazard ratios from the meta-analysis showed that the intervention significantly improved suture/healing failure, SSI, and hospital stay length. The certainty of evidence was “low” for suture/healing failure and SSI and “moderate” for hospital stay length. Conclusions: Perioperative management with enteral nutritional agents fortified with immunonutrients should be considered in adult patients scheduled for (advanced) oral cancer surgery.

摘要翻译： 

背景：本系统综述旨在评估免疫增强营养疗法相较于传统营养支持在降低口腔癌手术成年患者围手术期并发症方面的效果。鉴于免疫营养在这一特定手术情境中的作用尚不明确，我们综合现有随机对照试验数据，评估手术部位感染、伤口愈合并发症、住院时长及不良事件等结局指标。方法：纳入接受计划性口腔癌手术的患者。干预组在术前、术后或围手术期接受口服或肠内免疫增强营养制剂，对照组接受标准护理（静脉输液）和/或大分子营养补充剂。通过全面检索PubMed、Cochrane CENTRAL及Central Medical Journal数据库，最终纳入8项随机对照试验。主要结局指标包括死亡率、缝合/愈合失败、手术部位感染及住院时长，并采用GRADE分级系统对证据质量进行评估。结果：虽然无法进行死亡率评估，但荟萃分析的风险比显示干预措施显著改善了缝合/愈合失败、手术部位感染及住院时长。缝合/愈合失败与手术部位感染的证据质量为“低”，住院时长的证据质量为“中”。结论：对于计划接受（进展期）口腔癌手术的成年患者，应考虑采用添加免疫营养素的肠内营养制剂进行围手术期管理。

原文链接：

Beneficial Outcomes of Immunoenhancing Nutritional Interventions in Perioperative Care for Oral Cancer: A Systematic Review and Meta-Analysis