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手术康复促进护理以降低行肝切除术患者的手术部位伤口感染和术后并发症发生率。

Enhanced recovery after surgery care to reduce surgical site wound infection and postoperative complications for patients undergoing liver surgery.

机构信息

Department of Hepatobiliary, Taizhou Hospital of Zhejiang Province, Taizhou, Zhejiang, China.

Department of Admissions Management Centre, Taizhou Hospital of Zhejiang Province, Taizhou, Zhejiang, China.

出版信息

Int Wound J. 2023 Nov;20(9):3540-3549. doi: 10.1111/iwj.14227. Epub 2023 May 22.

DOI:10.1111/iwj.14227
PMID:37218367
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10588343/
Abstract

This study comprehensively assessed the effect of enhanced recovery after surgery (ERAS) on wound infection and postoperative complications in patients undergoing liver surgery. The PubMed, EMBASE, MEDLINE, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang electronic databases were searched to collect published studies on the use of ERAS in liver surgery until December 2022. Literature selection was performed independently by two investigators according to the inclusion and exclusion criteria, and quality evaluation and data extraction were performed. RevMan 5.4 software was used in this study. Compared with the control group, the ERAS group showed a significantly lower incidence of postoperative wound infection (odds ratio [OR]: 0.59, 95% confidence interval [CI]: 0.41-0.84, P = .004) and overall postoperative complication rate (OR: 0.43, 95% CI: 0.33-0.57, P < .001) and significantly shorter postoperative hospital stay (mean difference: -2.30, 95% CI: -2.92 to -1.68, P < .001). Therefore, ERAS was safe and feasible when applied to liver resection, reducing the incidence of wound infection and total postoperative complications, and shortening the length of hospital stay. However, further studies are required to investigate the impact of ERAS protocols on clinical outcomes.

摘要

本研究全面评估了加速康复外科(ERAS)对肝手术患者伤口感染和术后并发症的影响。检索了 PubMed、EMBASE、MEDLINE、Cochrane 图书馆、中国知网(CNKI)、维普和万方电子数据库,以收集截至 2022 年 12 月使用 ERAS 治疗肝手术的已发表研究。两名研究者根据纳入和排除标准独立进行文献筛选、质量评估和数据提取。本研究使用 RevMan 5.4 软件。与对照组相比,ERAS 组术后伤口感染发生率(比值比 [OR]:0.59,95%置信区间 [CI]:0.41-0.84,P=0.004)和总术后并发症发生率(OR:0.43,95%CI:0.33-0.57,P<0.001)显著降低,术后住院时间明显缩短(均数差:-2.30,95%CI:-2.92 至-1.68,P<0.001)。因此,ERAS 应用于肝切除术是安全可行的,可降低伤口感染和总术后并发症的发生率,缩短住院时间。然而,仍需要进一步研究来探讨 ERAS 方案对临床结局的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/03b479f76061/IWJ-20-3540-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/79f233c04170/IWJ-20-3540-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/738645cdea51/IWJ-20-3540-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/6e1878a09fa2/IWJ-20-3540-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/32e67a816818/IWJ-20-3540-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/328060f74f86/IWJ-20-3540-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/af5f8087fec9/IWJ-20-3540-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/03b479f76061/IWJ-20-3540-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/79f233c04170/IWJ-20-3540-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/738645cdea51/IWJ-20-3540-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/6e1878a09fa2/IWJ-20-3540-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/32e67a816818/IWJ-20-3540-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/328060f74f86/IWJ-20-3540-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/af5f8087fec9/IWJ-20-3540-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7810/10588343/03b479f76061/IWJ-20-3540-g005.jpg

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