基于加速康复外科护理对手术减肥患者有效性的系统评价与Meta分析

目的 评价加速康复外科护理对手术减肥患者的有效性。方法 计算机检索PubMed、Embase、Web of Sience、The Cochrane library、中国知网、中国生物医学文献、维普、万方数据库的文献,检索时间为建库至2019年12月31日。由2名研究员根据纳入与排除标准筛选文献、提取数据,对纳入文献采用RevMan 5.2软件进行Meta分析。结果 共纳入14篇研究,纳入患者10 044例。Meta分析结果显示,与传统围术期护理比较,加速康复外科护理可明显缩短手术减肥患者住院时长SMD=-2.33,95%CI(-3.43～-1.24),P＜0.0001];加速康复外科护理并未降低手术减肥患者再次入院率及术后相关并发症发生率OR=0.83,95%CI(0.68～1.00),P=0.05;OR=0.94,95%CI(0.81～1.10),P=0.44];同时部分文献报道加速康复外科理念的推广可降低减肥手术患者住院费用。结论 现有证据表明,加速康复外科护理可显著缩短手术减肥患者的住院时长,降低患者住院费用,但对术后再入院率及并发症无明显影响。鉴于本次研究证据质量有限,今后还应开展更多高质量的研究。

The effectiveness of fast track surgery care for patients undergoing bariatric surgery: a systematic review and Meta-analysis

Objective To evaluate the effectiveness of the fast track surgery care for patients undergoing the bariatric surgery. Methods Researches on the effectiveness of fast track surgery care for patients undergoing the bariatric surgery and published before year 2020 were searched in PubMed, Embase, Web of Sience, The Cochrane Library, CNKI, China Biomedical Literature, VIP and Wanfang database. All data were screen and extracted by two professionals and later conducted Meta analysis using the RevMan 5.2 software. Results A total of 14 studies were found, with 10044 patients included. Meta analysis results showed that fast track surgery care significantly shortened the length of hospitalization SMD=-2.33,95%CI(-3.43～-1.24),P<0.0001], did not reduce the readmission rate and the occurrence of related complications significantlyOR=0.83, 95%CI (0.68～1.00),P=0.05; OR=0.94, 95%CI (0.81～1.10), P=0.44]. It was partly reported that such practice significantly lowered the hospitalization cost. Conclusion The fast track surgery care can significantly shorten the length of hospitalization, and hospitalization cost for bariatric surgery patients, but has no effect on the readmission rate and the postoperative complications.