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Received:October 09, 2021 Published Online:May 20, 2022
Received:October 09, 2021 Published Online:May 20, 2022
中文摘要: 目的 采用Meta分析的方法评价加速康复外科(ERAS)理念应用于剖宫产围手术期的效果。方法 计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、EmBase及Cochrane Library数据库,根据纳入及排除标准筛选出相关文献并对其进行质量评价,提取一般资料及所需数据后采用Revman 5.3软件进行Meta分析。结果 纳入12篇随机对照试验进行Meta分析,结果显示,ERAS组患者术后首次排气时间( SMD =-1.61,95% CI -2.17~-1.04,P<0.01)、首次下床活动时间( SMD =-3.99,95% CI -5.34~-2.64,P<0.01)、初始泌乳时间( SMD =-2.91,95% CI -4.18~-1.65,P<0.01)及术后住院时间( SMD =-1.69,95% CI -2.33~-1.04,P<0.01)缩短,术后并发症发生率降低( RR =0.39,95% CI 0.30~0.50,P<0.01),住院费用减少( SMD =-15.76,95% CI -24.29~-7.23,P<0.01),差异有统计学意义。结论 将ERAS理念应用于剖宫产患者围术期中是安全有效的,可加速产妇身心恢复,减轻其家庭与社会的经济压力。
Abstract:Objective To evaluate the effect of enhanced recovery after surgery (ERAS) in the perioperative period of cesarean section by Meta analysis. Methods CNKI, Wanfang, VIP, Chinese Biomedical Literature Database, Pubmed, Embase, Cochrane library database were searched by computer. According to inclusion and exclusion criteria, the relevant literatures and required data were screened, extracted and evaluated for quality. Meta-analysis was performed with Revman 5.3 software. Results Twelve randomized controlled trials were included in the Meta-analysis. The results showed that the time to first postoperative flatus (SMD=-1.61,95%CI -2.17--1.04, P<0.01), the time to first postoperative off-bed activity ( SMD=-3.99,95%CI -5.34--2.64, P<0.01) , the initial lactation time ( SMD=-2.91,95%CI -4.18--1.65, P<0.01) , postoperative hospital stay ( SMD=-1.69,95%CI -2.33--1.04, P<0.01) , incidence of postoperative complications ( RR=0.39,95%CI 0.30-0.50, P<0.01) and hospital costs ( SMD=-15.76,95%CI -24.29--7.23, P<0.01) significantly shortened or decreased in the patients treated with ERAS compared with the patients with traditional perioperative nursing. Conclusion ERAS is safe and effective in the perioperative period of cesarean section patients. It can accelerate the physical and mental recovery of puerpera and relieve the economic pressure on their families and society.
keywords: Enhanced recovery after surgery Caesarean section Perioperative period Randomized controlled trial Meta-analysis Hospital cost Complication
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