Meta-analysis Of The Effect Of Intensive Nutrition On The Clinical Outcome Of Patients With Severe Traumatic Injury

Objective: To evaluate the effect of intensive nutrition on the clinical outcome of patients with severe traumatic injury.Methods: Randomized controlled studies on the effects of intensive nutrition on labor outcomes in patients with severe traumatic l injury were retrieved from PubMed,Cochrane Library,Embase,Wan Fang and CNKI databases by computer.The retrieval time was from the establishment of the database to June 11,2008,and the related literature was searched manually.Two researchers independently screened the literature,extracted data,and assessed the risk of inclusion bias.RevMan 5.3 statistical software provided by Cochrane Collaborative Network was used to merge the effects and Stata 12.0 software was used to detect publication bias.Results: a total of 39 articles were included and a total of 2895 subjects were included.Meta-analysis showed that the total protein level of the intervention group was higher than that of the general nutrition group(WMD = 4.96 g/L(1.57-8.34);P < 0.001);the IgA level of the intensive nutrition group was significantly higher than that of the general nutrition group(SMD = 0.79(0.51-1.07),P < 0.001);and the IgG level of the intensive nutrition group was higher than that of the general nutrition group(SMD = 0.98(0.98).58-1.38(P < 0.001);CD4/CD8 in patients with intensive nutrition was significantly higher than that in patients with general nutrition(WMD = 0.33(0.18-0.48)(P < 0.001);RR = 0.45(0.27-0.75),P = 0.002 in patients with traumatic injury were significantly reduced by intensive nutrition;and the infection rate in patients with intensive nutrition was significantly lower than that in general nutrition camp.In the nutrition group,RR = 0.48(0.39-0.61),(P < 0.001),the incidence of abdominal distension and diarrhea was reduced by 55% in the general nutrition group(RR = 0.45(0.35-0.58),P < 0.001),and the incidence of gastric retention in the patients with traumatic injury(RR = 0.19(0.07-0.49),P < 0.001).The results of three subgroup analysis showed that the total protein level and IgG level in early nutrition were better than those in late nutrition within 24 hours according to the starting time and the cut-off point of 24 hours,and the total protein level and IgA level in the intervention effect were higher than those of 30 ml/h and 30 ml/h according to the starting dose.IgG and CD4/CD8 were better than the dosage less than 30ml/h.According to the different nutritional methods,the sub-group analysis was carried out by enteral nutrition and parenteral nutrition.Among the indexes of enteral nutrition,the IgA level and the incidence of abdominal distension and diarrhea were better than parenteral nutrition.Conclusion: Intensive nutrition can effectively improve the nutritional indicators of patients,reduce the mortality of patients,reduce the occurrence of clinical complications,it is recommended to promote the use of clinical.