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加速康复外科对结直肠手术患者伤口感染、并发症和术后住院时间的影响:系统评价和荟萃分析。

The effects of enhanced recovery after surgery on wound infection, complications, and postoperative hospital stay in patients undergoing colorectal surgery: A systematic review and meta-analysis.

机构信息

Department of Gastrointestinal Surgery, Jinan City People's Hospital, Jinan, China.

Department of Continuing Care Center, Jinan City People's Hospital, Jinan, China.

出版信息

Int Wound J. 2023 Dec;20(10):3990-3998. doi: 10.1111/iwj.14287. Epub 2023 Aug 31.

Abstract

This study aimed to systematically evaluate the effects of enhanced recovery after surgery (ERAS) on surgical site infections, postoperative complications, and length of hospital stay in patients undergoing colorectal surgery. A comprehensive search was conducted of PubMed, Web of Science, Ovid, EMBASE, The Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data from database inception to April 2023 to identify relevant studies on the application of ERAS in colorectal surgery. Studies were screened, and data were extracted based on predetermined inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.4 software. A total of 22 studies, including 3702 patients (ERAS group: 1906; control group: 1796), were included in the final analysis. ERAS significantly reduced the incidence of surgical site infection (odds ratio [OR]: 0.49, 95% confidence interval [CI]: 0.34-0.69, p < 0.001), postoperative complications (OR: 0.33, 95% CI: 0.27-0.41, p < 0.001), and length of hospital stay (standardised mean difference: -1.22 days, 95% CI: -1.66 to -0.77 days, p < 0.001). These findings suggest that ERAS reduces the incidence of surgical site infections and postoperative complications and shortens the length of hospital stay in patients undergoing colorectal surgery. Therefore, ERAS should be promoted and applied in clinical practice.

摘要

本研究旨在系统评估加速康复外科(ERAS)对结直肠手术患者手术部位感染、术后并发症和住院时间的影响。从数据库建立到 2023 年 4 月,我们全面检索了 PubMed、Web of Science、Ovid、EMBASE、The Cochrane Library、中国知网(CNKI)和万方数据,以确定有关 ERAS 在结直肠手术中应用的相关研究。根据预先设定的纳入和排除标准筛选研究并提取数据。使用 RevMan 5.4 软件进行荟萃分析。最终分析纳入了 22 项研究,共 3702 例患者(ERAS 组:1906 例;对照组:1796 例)。ERAS 显著降低了手术部位感染的发生率(比值比 [OR]:0.49,95%置信区间 [CI]:0.34-0.69,p<0.001)、术后并发症的发生率(OR:0.33,95% CI:0.27-0.41,p<0.001)和住院时间(标准化均数差:-1.22 天,95% CI:-1.66 至-0.77 天,p<0.001)。这些发现表明,ERAS 可降低结直肠手术患者手术部位感染和术后并发症的发生率,并缩短住院时间。因此,ERAS 应在临床实践中得到推广和应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad67/10681523/5417bafeb616/IWJ-20-3990-g006.jpg

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