双腔胆管-肠内营养管对恶性阻塞性黄疸患者的疗效

IF 2 4区 医学 Q3 NUTRITION & DIETETICS Nutrition and Cancer-An International Journal Pub Date : 2024-09-26 DOI:10.1080/01635581.2024.2408041
Jian-Hua Cao, Ke-Fu Wu, Gao-Xiang Li, Jie Chen, Zhan-Hu Mu, Hai-Min Li, Jian-Jun Yao, Xue-Wen Yang
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引用次数: 0

摘要

研究目的本研究旨在评估双腔胆肠管(DBET)用于恶性梗阻性黄疸(MOJ)患者肠内营养(EN)的疗效:利用前瞻性维护的单中心数据库中的数据进行了一项回顾性队列研究,研究对象包括 MOJ 患者。在干预组中,DBET置入术与经皮经肝胆管引流术和胆道支架置入术同时进行,然后进行术后EN(DBET-EN)。在对照组中,内镜胆道支架术后进行深静脉导管插入术,并提供肠外营养(PN)。采用多变量广义线性模型评估DBET-EN与6个月死亡率之间的关系:本研究共纳入 74 例患者,其中干预组(DBET-EN 组)28 例,对照组(PN 组)46 例。在 6 个月的随访中,DBET-EN 组有 5 名患者(17.9%)死亡,PN 组有 20 名患者(43.5%)死亡。多变量广义线性模型显示,与 PN 组相比,DBET-EN 组的 6 个月死亡率明显降低(调整后的几率比 [OR]:0.25,95% CI:0.08-0.81,P = 0.020)。次要结果显示,与 PN 组相比,DBET-EN 组患者的 9 个月死亡率更低,插管保留时间更长(所有调整后 P P 结论:DBET-EN 组患者的 9 个月死亡率更低,插管保留时间更长:事实证明,对 MOJ 晚期患者实施 DBET-EN 是一种微创、安全的干预措施。它能明显改善患者的营养状况和生活质量,同时降低死亡率。
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Efficacy of Double-Lumen Biliary-Enteric Tube in Enteral Nutrition for Patients with Malignant Obstructive Jaundice.

Objective: This study aimed to evaluate the efficacy of a double-lumen biliary-enteric tube (DBET) for enteral nutrition (EN) in individuals with malignant obstructive jaundice (MOJ).

Methods: A retrospective cohort study was conducted using data from a prospectively maintained single-center database, including patients with MOJ. In the intervention group, DBET placement was performed concurrently with percutaneous transhepatic cholangiodrainage and biliary stenting, followed by postoperative EN (DBET-EN). In the control group, deep vein catheterization was undertaken after endoscopic biliary stenting, and parenteral nutrition (PN) was provided. A multivariable generalized linear model was used to assess the association between DBET-EN and 6-month mortality.

Results: A total of 74 patients were included in this study, comprising 28 patients in the intervention group (DBET-EN group) and 46 patients in the control group (PN group). Within the 6-month follow-up, 5 patients (17.9%) in the DBET-EN group and 20 (43.5%) in the PN group died. The multivariable generalized linear model demonstrated a significantly reduced 6-month mortality in the DBET-EN group compared to the PN group (adjusted odds ratio [OR]: 0.25, 95% CI: 0.08-0.81, P = 0.020). Secondary outcomes indicated that patients in the DBET-EN group had lower 9-month mortality rates and longer tube retention durations compared to the PN group (all adjusted P < 0.05). Postoperative liver function improved similarly in both groups. At 3, 6, and 9 months postoperatively, patient-generated subjective global assessment (PG-SGA) scores and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) scores were significantly higher in the DBET-EN group than in the PN group (P < 0.05).

Conclusion: The implementation of DBET for EN in patients in the advanced stage of MOJ proved to be a minimally invasive and safe intervention. It significantly improved patients' nutritional status and quality of life while reducing mortality.

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来源期刊
CiteScore
5.80
自引率
3.40%
发文量
172
审稿时长
3 months
期刊介绍: This timely publication reports and reviews current findings on the effects of nutrition on the etiology, therapy, and prevention of cancer. Etiological issues include clinical and experimental research in nutrition, carcinogenesis, epidemiology, biochemistry, and molecular biology. Coverage of therapy focuses on research in clinical nutrition and oncology, dietetics, and bioengineering. Prevention approaches include public health recommendations, preventative medicine, behavior modification, education, functional foods, and agricultural and food production policies.
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