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快速康复外科（FTS）在髋部骨折手术后患者中的疗效和安全性：一项荟萃分析。

The efficacy and safety of fast track surgery (FTS) in patients after hip fracture surgery: a meta-analysis.

机构信息

Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

Guangxi Medical University, Nanning, Guangxi, China.

出版信息

J Orthop Surg Res. 2021 Feb 27;16(1):162. doi: 10.1186/s13018-021-02277-w.

DOI:10.1186/s13018-021-02277-w
PMID:33639957
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7913454/
Abstract

BACKGROUND

Fast track surgery (FTS) has been gradually applied in perioperative management of orthopedic surgery, but there still some research suspected that the prognosis of patients is not as expected and the cost is high, the effect of the FTS still urgently needed for support by evidence-based medicine.

METHODS

We retrieved RCTs from medical research literature databases. Risk ratios (RR), standard mean difference (SMD), and 95% confidence intervals (CI) were calculated to compare the primary and safety endpoints.

RESULTS

Overall, a total of 8886 patients were retrieved from 57 articles, of which 4448 patients (50.06%) were randomized to experimental group whereas 4438 patients (49.94%) were randomized to control group. The result showed that FTS could significantly shorten the length of stay (LOS), decrease the visual analog scale (VAS), reduce the leaving bed time and the hospitalization costs, and improve Harris hip joint function score. The incidence of complications such as respiratory system infection, urinary system infection, venous thrombus embolism (VTE), pressure sore, incision infection, constipation, and prosthesis dislocation also has been decreased significantly. Meanwhile, FTS improved patients' satisfaction apparently.

CONCLUSIONS

This meta-analysis reveals that FTS could significantly shorten the length of stay, alleviate the pain, reduce the leaving bed time and the hospitalization costs, and improve hip function. The incidence of complications also has been decreased significantly. Meanwhile, FTS has been spoken highly in patients in terms of nursing satisfaction. Its efficacy and safety were proved to be reliable.

摘要

背景

快速康复外科（FTS）已逐渐应用于骨科围手术期管理，但仍有一些研究怀疑患者的预后不如预期，且费用较高，FTS 的效果仍迫切需要循证医学的支持。

方法

我们从医学研究文献数据库中检索 RCTs。计算风险比（RR）、标准均数差（SMD）和 95%置信区间（CI），以比较主要和安全性终点。

结果

总体而言，从 57 篇文章中检索到 8886 名患者，其中 4448 名患者（50.06%）被随机分配到实验组，4438 名患者（49.94%）被随机分配到对照组。结果表明，FTS 可显著缩短住院时间（LOS），降低视觉模拟量表（VAS）评分，缩短离床时间和住院费用，提高 Harris 髋关节功能评分。呼吸系统感染、泌尿系统感染、静脉血栓栓塞（VTE）、压疮、切口感染、便秘和假体脱位等并发症的发生率也显著降低。同时，FTS 明显提高了患者的满意度。

结论

这项荟萃分析表明，FTS 可显著缩短住院时间，减轻疼痛，缩短离床时间和住院费用，改善髋关节功能。并发症的发生率也显著降低。同时，FTS 在患者的护理满意度方面也得到了高度评价。其疗效和安全性得到了证实。

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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7bc/7913454/877af1ab9309/13018_2021_2277_Fig11_HTML.jpg
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