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Received:June 20, 2022 Published Online:September 20, 2022
Received:June 20, 2022 Published Online:September 20, 2022
中文摘要: 目的 研究加速康复外科(ERAS)理念在妇科恶性肿瘤患者围手术期的应用效果。方法 检索PubMed、EMBASE、Web of Science、Cochrane library、中国知网(CNKI)、万方、维普以及中国生物医学文献数据库(CBM)。检索自数据库建库至2021年10月发表的 ERAS理念与传统理念在妇科恶性肿瘤患者围手术期应用效果比较的临床试验,包括随机对照研究(RCT)、队列研究和病例-对照研究。采用Cochrane风险偏倚工具和纽卡斯尔-渥太华量表分别对RCT和非RCT进行文献质量评价。选用RevMan 5.4软件进行Meta分析。结果 最终共纳入28篇研究,一共3 901例患者。其中,试验组1 897例,对照组2 004例。Meta分析结果显示,ERAS组与传统组相比,手术时间,术后首次排气排便、下床活动及进食时间,术后住院时间,术后并发症发生率差异均有统计学意义(P<0.01)。结论 与传统理念相比,妇科恶性肿瘤患者围手术期应用 ERAS 理念可缩短手术时间以及术后首次排气排便、下床活动及进食时间和术后住院时间,可减少术后并发症发生率,是安全可行的措施。
Abstract:Objective To investigate the effect of enhanced recovery after surgery (ERAS) in the perioperative management of gynecological malignant tumor patients. Methods Eight databases including PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, Wanfang, VIP and CBM were searched. The clinical trials comparing the effect of ERAS concept and traditional concept in the perioperative period of gynecological malignant tumor patients from the establishment of the database to October 2021 were retrieved, including randomized controlled trails (RCT), cohort studies and case-control studies. Cochrane risk bias tool and Newcastle Ottawa scale were used to evaluate the literature quality of RCT and non-RCT respectively. Revman 5.4 was selected for Meta-analysis. Results There were 28 studies included eventually, with a total of 3 901 patients. Among them, there were 1 897 cases in the experimental group and 2 004 cases in the control group. Meta-analysis showed that there were significant differences between ERAS group and traditional group in the operation time, the time of the first postoperative exhaust and defecation, getting out of bed and eating, the postoperative hospital stay, and the incidence of postoperative complications (P<0.01). Conclusion Compared with the traditional concept, the perioperative application of ERAS concept in gynecological malignant tumor patients can shorten the operation time, the time of the first postoperative exhaust and defecation, getting out of bed and eating, and the postoperative hospital stay, and reduce the incidence of postoperative complications, which is a safe and feasible measure.
keywords: Enhanced recovery after surgery Gynecological malignant tumor Cervical cancer Endometrial carcinoma Oophoroma Perioperative period
文章编号: 中图分类号:R737.7 文献标志码:A
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