| 妇科腹部手术术后快速康复外科路径的应用效果评价与meta分析 |
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| 引用本文： | 邬晓梅,杨志娟,郭敏,陈娟,侯海燕. 妇科腹部手术术后快速康复外科路径的应用效果评价与meta分析[J]. 国际医药卫生导报, 2022, 28(5): 681-686. DOI: 10.3760/cma.j.issn.1007-1245.2022.05.020 |
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| 作者姓名： | 邬晓梅 杨志娟 郭敏 陈娟 侯海燕 |
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| 作者单位： | 1天津美津宜和妇儿医院妇产科，天津 300381；2中国人民武装警察部队特色医学中心，天津 300300 |
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| 基金项目： | 天津市自然科学基金项目（15JCQNJC12300） |
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| 摘 要： | 目的:快速康复外科路径已被广泛接受且应用于不同类型的手术，但是在妇科腹部手术中的应用效果尚不明确。本文利用系统评价和meta分析的方法回顾了目前已有的证据，探讨快速康复外科理念对妇科腹部手术术后结局的影响。方法:采用Cochrane系统评价的方法，计算机检索PubMed、EMbase、Cochrane Library、...
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| 关 键 词： | 妇科手术 快速康复外科 围术期管理 住院时间 |
| 收稿时间： | 2021-10-09 |
A meta-analysis and evaluation on effect of enhanced recovery after surgery pathway in abdominal gynecologic surgery |
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| Wu Xiaomei,Yang Zhijuan,Guo Min,Chen Juan,Hou Haiyan. A meta-analysis and evaluation on effect of enhanced recovery after surgery pathway in abdominal gynecologic surgery[J]. International Medicine & Health Guidance News, 2022, 28(5): 681-686. DOI: 10.3760/cma.j.issn.1007-1245.2022.05.020 |
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| Authors: | Wu Xiaomei Yang Zhijuan Guo Min Chen Juan Hou Haiyan |
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| Affiliation: | 1 Department of Gynaecology and obstetrics, Tianjin Women's andChildren's Hospital, Tianjin 300381, China; 2 Chinese People's ArmedPolice Force Characteristic Medical Center, Tianjin 300300, China |
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| Abstract: | Objective Enhanced recovery after surgery has been widely accepted and implementedfor different types of surgery. Their overall effect in abdominal gynecologicsurgery is still underdetermined. A systematic review and meta-analysis wereperformed to provide an overview of current evidences and to examine theireffect on postoperative outcomes in women undergoing open gynecologic surgery. Methods We used systematic review research methods ofCochrane. The literatures were searched from PubMed, EMbase, Cochrane Library,CBM, CNKI, Wan Fang, and VIP databases from their establishment to May 2020.The studies applying enhanced recovery after surgery theory in abdominalgynecologic surgery which met the inclusion and exclusion criteria and haddescribed 4 individualized intervention measures were collected. Two evaluatorsscreened the literatures, extracted the information, and evaluated the qualityindependently. The meta-analysis was made by RevMan 5.3. The outcome indicatorsincluded hospital stay, incidence of complications, re-admission rate, and casefatality rate. Quantitative analysis was made on the studies with controls. Theefficacy was presented as relative risk (RR),mean differences (MD), and 95%confidence intervals (CI). Results Seventeen observation studies were included.Heterogeneity analysis was made on the studies. All the pathways includedpreoperative education, early oral medication, and early mobilization. Comparedwith peri-operative treatment, enhanced recovery after surgery pathway reducedthe first and total hospitalization times (MD=-2.10,95%CI -2.67～-1.52; MD=-3.42, 95%CI -3.96～-2.88), and did not increase the incidence of complications, casefatality rate , and re-admission rate. Conclusion The available evidences based on a broad range of non-randomized studiesat high risk of bias suggests that enhanced recovery after surgery may reducepostoperative hospital stay in abdominal gynecologic surgery, so more highquality studies are needed to prove it. |
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| Keywords: | Gynecologic surgery Enhanced recovery after surgery Perioperative management Hospital stay |
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