中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
Chinese Journal of Clinical Nutrition
2015年
5期
296-301
,共6页
赵海桃%谢海雁%于康%李冬晶
趙海桃%謝海雁%于康%李鼕晶
조해도%사해안%우강%리동정
质量生命调整年%营养支持%营养风险
質量生命調整年%營養支持%營養風險
질량생명조정년%영양지지%영양풍험
Quality adjusted life year%Nutrition support%Nutritional risk
目的 总结近年发表文献中营养支持对存在营养风险的老年患者的质量生命调整年(QALY)的影响,同时评价以QALY为结局指标的可行性.方法 计算机检索1980至2013年万方数据知识服务平台、中国知网、PubMed、Nature等,查找已经发表的以"营养支持对有营养风险的患者的结局的影响用QALY和成本效用评价的可行性是怎样的?"为研究问题的中、英、日文文献.采用Jadad量表结合Schulz隐蔽分组对随机对照研究的质量进行评价,采用Newcastle-Ottawa量表对队列研究的质量进行评价.结果 共检索到10篇文献,6篇随机对照试验,2篇队列研究,余2篇不符合要求予以排除.共计1 130例患者.6个随机对照试验有4篇试验组QALY高于对照组、总费用试验组低于对照组(或成本效益试验组高于对照组).2个队列研究的结果表明对长期营养不良的患者进行长期在家庭环境下的全胃肠外营养支持可以改善患者的QALY,而且成本比需要在医院提供营养支持时的成本小.结论 对存在营养风险的患者进行营养支持可以改善患者预后并可以减少成本,提高QALY.今后需要更多样本容量更大、质量较高的随机对照研究评价营养支持对存在营养风险的老年患者的QALY的影响.
目的 總結近年髮錶文獻中營養支持對存在營養風險的老年患者的質量生命調整年(QALY)的影響,同時評價以QALY為結跼指標的可行性.方法 計算機檢索1980至2013年萬方數據知識服務平檯、中國知網、PubMed、Nature等,查找已經髮錶的以"營養支持對有營養風險的患者的結跼的影響用QALY和成本效用評價的可行性是怎樣的?"為研究問題的中、英、日文文獻.採用Jadad量錶結閤Schulz隱蔽分組對隨機對照研究的質量進行評價,採用Newcastle-Ottawa量錶對隊列研究的質量進行評價.結果 共檢索到10篇文獻,6篇隨機對照試驗,2篇隊列研究,餘2篇不符閤要求予以排除.共計1 130例患者.6箇隨機對照試驗有4篇試驗組QALY高于對照組、總費用試驗組低于對照組(或成本效益試驗組高于對照組).2箇隊列研究的結果錶明對長期營養不良的患者進行長期在傢庭環境下的全胃腸外營養支持可以改善患者的QALY,而且成本比需要在醫院提供營養支持時的成本小.結論 對存在營養風險的患者進行營養支持可以改善患者預後併可以減少成本,提高QALY.今後需要更多樣本容量更大、質量較高的隨機對照研究評價營養支持對存在營養風險的老年患者的QALY的影響.
목적 총결근년발표문헌중영양지지대존재영양풍험적노년환자적질량생명조정년(QALY)적영향,동시평개이QALY위결국지표적가행성.방법 계산궤검색1980지2013년만방수거지식복무평태、중국지망、PubMed、Nature등,사조이경발표적이"영양지지대유영양풍험적환자적결국적영향용QALY화성본효용평개적가행성시즘양적?"위연구문제적중、영、일문문헌.채용Jadad량표결합Schulz은폐분조대수궤대조연구적질량진행평개,채용Newcastle-Ottawa량표대대렬연구적질량진행평개.결과 공검색도10편문헌,6편수궤대조시험,2편대렬연구,여2편불부합요구여이배제.공계1 130례환자.6개수궤대조시험유4편시험조QALY고우대조조、총비용시험조저우대조조(혹성본효익시험조고우대조조).2개대렬연구적결과표명대장기영양불량적환자진행장기재가정배경하적전위장외영양지지가이개선환자적QALY,이차성본비수요재의원제공영양지지시적성본소.결론 대존재영양풍험적환자진행영양지지가이개선환자예후병가이감소성본,제고QALY.금후수요경다양본용량경대、질량교고적수궤대조연구평개영양지지대존재영양풍험적노년환자적QALY적영향.
Objective To summarize the progress of research on the influence of nutrition support on quality adjusted life year (QALY) in elderly patients with nutritional risk, and to evaluate the feasibility of QALY as an outcome indicator.Methods Literature in Chinese, English and Japanese relating to "the feasibility of QALY and cost-utility in evaluating the influence of nutrition support on the outcomes of patients with nutritional risk" published from 1980 to 2013 were searched in Wanfang, China National Knowledge Infrastructure,PubMed, Nature databases.The methodological quality of randomized controlled trials was assessed using Jadad scale combined with Schulz allocation concealment, and the quality of cohort studies with Newcastle-Ottawa scale.Results Totally 10 articles were fotnd, in which 8 were selected, including 6 randomized controlled trial and 2 cohort studies, covering 1 130 patients;the other 2 were excluded for not conforming to inclusion criteria.Four of the 6 randomized controlled trial indicate that QALY is higher and all-cost is lower in the treatment group compared with the control group (or cost-utility is higher in the treatment group).The 2 cohort studies indicate that total parenteral nutrition support at home could improve the QALY of malnourished patients and could save cost compared with nutrition support at hospital when necessary.Conclusions Nutrition support for patients with nutritional risk can improve prognosis, reduce cost, and increase QALY.More large-scale, high-quality randomized controlled trials are needed to evaluate the effect of nutrition support on the QALY of elderly patients with nutritional risk.
