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快速康复外科对食管癌全腔镜切除术患者护理效果的系统评价与Meta分析：快速康复外科护理与常规护理对比

A systematic review and meta-analysis of nursing effect of fast-track recovery surgery on patients undergoing total endoscopic resection of esophageal cancer: fast-track recovery surgery nursing care as usual.

作者信息

Jia Yujie, Xing Jiahui, Li Yue, Du Jing, Li Linfeng

机构信息

Thoracic Surgery, Peking Union Medical College Hospital, Beijing, China.

Urology Surgery, Peking Union Medical College Hospital, Beijing, China.

出版信息

J Gastrointest Oncol. 2023 Apr 29;14(2):572-584. doi: 10.21037/jgo-23-101. Epub 2023 Apr 24.

DOI:10.21037/jgo-23-101
PMID:37201066
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10186530/
Abstract

BACKGROUND

Esophageal cancer (EC) is the 6th leading cause of cancer-related deaths worldwide, and the morbidity and mortality of EC have continued to increase in recent years. The results of the clinical application of the Fast-track recovery surgery (FTS) concept in nursing interventions for EC patients after total endoscopic esophagectomy are unconvincing. This study sought to evaluate the nursing effect of the fast-track recovery surgical nursing model on patients with EC after total cavity endoscopic esophagectomy.

METHODS

We searched for articles on case-control trials about nursing interventions after total endoscopic esophagectomy. The search time was set from January 2010 to May 2022. The data were independently extracted by 2 researchers. RevMan5.3 statistical software (Cochrane) was used to analyze the extracted data. All the articles included in the review were assessed for risk of bias using the Cochrane Handbook 5.3 (https://training.cochrane.org/).

RESULTS

Ultimately, 8 clinical controlled trials, comprising 613 cases, were identified. A meta-analysis was conducted of the extubation times, and the results showed that the study group's extubation times were remarkably shorter. In relation to the exhaust times, the study group had significantly shorter exhaust times than control group (P<0.05). In relation to the time, it took patients to leave bed, patients in the study group left bed in a considerably shorter time compared with controls (P<0.00001). In relation to the hospitalization time, a remarkable reduction in the length of hospital stay was observed in the study group (P<0.00001). The analysis of the funnel plots showed a small number of asymmetries, suggesting that the number of articles included was small due to the heterogeneity of the studies (P<0.00001).

CONCLUSIONS

FTS care is effective at accelerating patients' postoperative recovery. This model of care needs to be further validated in the future by higher-quality and longer follow-up studies.

摘要

背景

食管癌是全球第六大致癌死亡原因，近年来其发病率和死亡率持续上升。快速康复外科（FTS）理念在全腔镜食管癌切除术后护理干预中的临床应用效果尚不明确。本研究旨在评估快速康复外科护理模式对全腔镜食管癌切除术后患者的护理效果。

方法

我们检索了关于全腔镜食管癌切除术后护理干预的病例对照试验文章。检索时间设定为2010年1月至2022年5月。数据由2名研究人员独立提取。使用RevMan5.3统计软件（Cochrane）对提取的数据进行分析。使用Cochrane手册5.3（https://training.cochrane.org/）对纳入综述的所有文章进行偏倚风险评估。

结果

最终，确定了8项临床对照试验，共613例病例。对拔管时间进行了荟萃分析，结果显示研究组的拔管时间明显更短。关于排气时间，研究组的排气时间明显短于对照组（P<0.05）。关于患者下床时间，研究组患者下床时间比对照组短得多（P<0.00001）。关于住院时间，研究组的住院时间明显缩短（P<0.00001）。漏斗图分析显示存在少量不对称性，表明由于研究的异质性，纳入的文章数量较少（P<0.00001）。

结论

FTS护理在加速患者术后康复方面是有效的。这种护理模式未来需要通过更高质量和更长时间的随访研究进一步验证。

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