摘要:目的:系统评价肠内营养在人工膝关节置换术患者中的应用效果.方法:通过计算机检索Pubmed、Embase、Cochrane Library、Ebsco (CINAHL)、Sciencedirect、Springer,中国知网、万方、中国生物医学文献数据库、维普数据库,纳入实验组以肠内营养为干预措施,对照组为安慰剂的随机对照研究,并按Cochrane的系统评价方法,由2位评价员根据相关标准各自独立对文献进行评价及数据提取.结果:共纳入4项研究,总样本量为320例,其中实验组166例、对照组154例.Meta分析结果显示,实验组与对照组比较,术后两周[SMD=0.46,95%CI(-0.05,0.97)]与术后4~6周[SMD=0.61,95%CI(-0.05,1.28)]的股四头肌肌力的比较,差异均无统计学意义(P>0.05).但进行亚组分析后得出术后股四头肌肌力[SMD=-0.30,95% CI (0.16,0.85)],差异有统计学意义(P<0.05);两组住院时间[SMD=-0.37,95%CI(-0.61,-0.12)]以及术后两周疼痛评分[SMD=-0.27,95%CI(-0.51,-0.02)]的的比较,差异均具有统计学意义(P<0.05).结论:肠内营养的应用可以改善TKA患者术后股四头肌肌力,并能降低患者的疼痛水平以及缩短住院时间,但由于纳入的文献数量以及相关结局指标较少,肠内营养对于促进术后康复,以及减少TKA患者术后并发症的发生等方面,尚需更多高质量的研究来进一步确证其成效.%[Objective] To evaluate the effect of entemal nutrition on outcome of patients following total knee arthroplasty.[Method] All randomized controlled trials (RCTs) concerning the effect of enternal nutrition on the outcome of patients following total knee arthroplasty were identified from PubMed,Embase,the Cochrane Library,Ebsco (CINAHL),Sciencedirect,Springer,CNKI,Wanfang,CBM,and VIP Database.Meta-analysis was conducted by using the statistical software RevMan 5.3 and the quality of the RCTs was strictly evaluated by the Cochrane Handbook.[Result] A total of 4 RCTs involving 320 patients (166 patients in the enternal nutrition group and 154 patients in the control group) were included in this study.Statistical differences were found between the two groups in the strength of quadriceps 2 weeks and 4-6weeks after surgery through subgroup analysis [SMD =3.00,95% CI (1.01,4.99)],length of stay [SMD =-0.30,95% CI (-0.49,-0.11)],and pain score 2 weeks after surgery [SMD =-0.32,95% CI (-0.62,-0.03)].[Conclusion] Patients with enternal nutrition could improve the strength of quadriceps after surgery,and decrease the pain level and length of stay.However,the efficacy of enternal nutrition needs further investigation in high-quality evidence in the future.