摘要
目的:比较低身体质量指数(BMI)的结直肠癌患者与正常身体质量指数患者术后近期(30 d)死亡率的风险,为临床实践提供参考。方法:计算机检索PubMed、Embase、中国知网、万方数据库关于不同身体质量指数的结直肠癌患者术后短期死亡风险的临床研究,检索时限为建库至2019年1月。由两位作者对文献进行筛选并提取纳入研究的相关数据。采用RevMan软件根据异质性大小对提取的数据进行Meta分析。结果:共纳入9篇研究,其中7篇为回顾性队列研究,2篇为前瞻性队列研究。Meta分析结果提示,相对于正常BMI患者,BMI过小的患者(BMI<20 kg/m2)接受结直肠癌手术治疗术后30 d内死亡风险明显增加(OR=1.85,95%CI:1.50~2.28,P<0.0001)。对混杂因素校正后,结果仍然保持一致(OR=1.99,95%CI:1.16~3.39)。亚组分析提示,肿瘤部位、地区之间没有明显亚组效应。发表偏倚检测提示存在明显发表偏倚。结论:基于当前证据,低BMI的结直肠癌患者在实施结肠癌手术后,30 d内死亡风险较正常BMI的患者高。但鉴于本研究存在一定的缺陷,该结论需要更多的研究进一步证实。
Objective:To compare the risk of postoperative 30-day mortality of underweight colorectal can-cer patients with that of normal weight patients,in order to provide evidence for clinical practice.Methods:PubMed,Embase,CNKI,and Wanfang databases,from inception to January 2019,were searched for clinical studies on short-term postoperative death risk of colorectal cancer patients with different body mass index(BMI).Literatures were screened and data were extracted by two authors in-dependently.The RevMan software was used to perform the meta-analysis on the extracted data,based on the amount of heterogeneity.Results:A total of 9 studies were included,of which 7 were retrospective studies and 2 were prospective cohort studies.The results of our meta-analysis suggest-ed that compared with normal weight patients,the risk of death within 30 days after colorectal cancer surgery was significantly increased in underweight patients(BMI<20 kg/m2)(OR=1.85,95%CI:1.50~2.28,P<0.0001).After adjusting for confounding factors,the results remained consistent(OR=1.99,95%CI:1.16~3.39).Subgroup analysis indicated that there was no significant sub-group effect among tumor sites and regions.The publication bias test indicated the existence of signifi-cant publication bias.Conclusion:Based on current evidence,underweight patients of colorectal can-cer have a higher risk of postoperative death within 30 days than patients of normal weight.However,given the limitations,this conclusion needs to be further confirmed by more studies.
作者
杨晶莹
钟妮娜
高文静
黄静宇
YANG Jingying;ZHONG Nina;GAO Wenjing;HUANG Jingyu(Dept.of Anesthesia Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China;Dept.of Thoracic Surgery(Tumor Ward),Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2020年第2期249-254,共6页
Medical Journal of Wuhan University
关键词
结直肠癌
术后
身体质量指数
死亡率
Colorectal Cancer
Postoperation
Body Mass Index
Mortality
作者简介
杨晶莹,女,1993-,主要从事结直肠癌围手术期管理的研究,E-mail:459375405@qq.com;通讯作者:黄静宇,男,1983-,医学博士,主治医师,主要从事肿瘤的发病机制及治疗的研究,E-mail:huangjingyu1009@163.com
