胃手术老年患者早期静脉补充支链氨基酸营养:随机临床试验。

IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Nutrition Journal Pub Date : 2024-11-05 DOI:10.1186/s12937-024-01041-0
Yimei Ma, Xining Zhao, Yan Pan, Yuying Yang, Ying Wang, Shengjin Ge
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引用次数: 0

摘要

背景:术后补充肠外营养的开始时间和配方需要优化,尤其是对于接受大型胃肠道手术的老年患者。本研究旨在评估早期补充富含支链氨基酸(BCAA)的配方(BAF)对接受胃部手术的老年患者术后短期预后的影响:这项单中心、前瞻性、双盲、随机临床试验于 2020 年 3 月 10 日至 2022 年 9 月 15 日进行。年龄在 65-80 岁之间、计划接受根治性切除术的胃癌患者接受资格评估,并随机分配到高比例 BCAA (HBCAA) 组(早期补充 BAF)或对照组(常规营养)。主要结果是标准化住院时间(LOS):共有 150 名患者接受了随机治疗。13名患者因切除其他器官、出现转移或撤回同意书而被排除在外。最后,我们将 70 名和 67 名患者分别纳入 HBCAA 组和对照组(平均年龄:70.5 ± 4.2 岁;96 名男性 [70.1%])。治疗组的标准化住院日明显短于对照组(中位数[四分位数间距]:8.0 [7.8, 8.0] 天 vs. 8.5 [8.0, 9.0] 天;平均差异:0.38;95% 置信区间[CI]:0.02-0.74 天;P 结论:治疗组的标准化住院日明显短于对照组:在这项随机临床试验中,与常规营养相比,在接受胃部手术的老年患者中,早期补充BAF与缩短标准化住院日有关,这表明对于外部营养耐受性差且接受大手术的患者来说,BAF可能是一种有利的策略:试验注册:ClinicalTrials.gov;Identifier:试验注册:ClinicalTrials.gov;标识符:ChiCTR2000029635。
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Early intravenous branched-chain amino acid-enriched nutrition supplementation in older patients undergoing gastric surgery: a randomized clinical trial.

Background: The initiation time and formula for supplemental parenteral nutrition after surgery require optimization, especially in older patients undergoing major gastrointestinal surgery. This study aimed to assess the effect of early supplementation with a branched-chain amino acid (BCAA)-enriched formula (BAF) on short-term postoperative outcomes in older patients undergoing gastric surgery.

Methods: This single-center, prospective, double-blinded, randomized clinical trial was conducted from March 10, 2020, to September 15, 2022. Patients aged 65-80 years with gastric cancer scheduled for curative resection were assessed for eligibility and randomly allocated to a high-proportion BCAA (HBCAA) (early supplementation with the BAF) or control (routine nutrition) group. The primary outcome was the standardized length of hospital stay (LOS).

Results: A total of 150 patients were randomized. Thirteen patients were excluded due to the resection of other organs, presence of metastasis, or withdrawal of consent. Finally, we included 70 and 67 patients in the HBCAA and control groups, respectively (mean age: 70.5 ± 4.2 years; 96 men [70.1%]). The standardized LOS was significantly shorter in the treatment group than in the control group (median [interquartile range]: 8.0 [7.8, 8.0] vs. 8.5 [8.0, 9.0] days; mean difference, 0.38; 95% confidence interval [CI], 0.02-0.74 days; P < .001). Patients in the HBCAA group showed better gastrointestinal function with faster defecation (4.0 [3.6, 5.0] vs. 5.0 [4.0, 5.5] days; mean difference, 0.6 days; 95% CI, 0.26-0.94 days; P < .001) and semi-liquid diet initiation (8.0 [7.5, 8.0] vs. 8.0 [8.0, 8.8] days; mean difference, 0.36 days; 95% CI, 0.03-0.7 days; P < .001) and had lesser weight loss at postoperative day 5 than those in the control group did (3.5 [2.7, 6.5] vs. 4.9 [3.3, 7.6]%; mean difference, 1.23%; 95% CI, 0.27-2.19%; P = .011).

Conclusions: In this randomized clinical trial, compared with routine nutrition, early supplementation with a BAF was associated with a shorter standardized LOS in older patients undergoing gastric surgery, suggesting that it may be a favorable strategy for patients with a poor tolerance to external nutrition who are undergoing major surgery.

Trial registration: ClinicalTrials.gov; Identifier: ChiCTR2000029635.

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来源期刊
Nutrition Journal
Nutrition Journal NUTRITION & DIETETICS-
CiteScore
9.80
自引率
0.00%
发文量
68
审稿时长
4-8 weeks
期刊介绍: Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered. Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies. In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.
期刊最新文献
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