Department of Gastroenterology, Chongqing University Cancer Hospital, Chongqing, China.
Department of General Internal Medicine, Chongqing University Cancer Hospital, Chongqing, China.
Int Wound J. 2024 Mar;21(3):e14490. doi: 10.1111/iwj.14490. Epub 2023 Nov 16.
Our study aimed to investigate the effects of an enhanced recovery after surgery (ERAS) nursing program on surgical site wound infections (SSWI) and postoperative complications in patients undergoing laparoscopic hepatectomy (LH) for hepatocellular carcinoma. Computer searches of the PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure and Wanfang databases were conducted to gather randomised controlled trials (RCTs) that were published from inception to September 2023. The target studies evaluated the effects of the ERAS nursing program in patients undergoing LH for hepatocellular carcinoma. Two independent authors screened the literature, extracted the data and performed quality assessments. Dichotomous variables were analysed using odds ratios (ORs) and 95% confidence intervals (CIs), as effect analysis statistics. Stata software (version 17.0) was used for data analysis. Eleven RCTs with 765 patients were included, with 383 patients in the ERAS group and 382 in the control group. The results revealed that the incidence of SSWI (OR = 0.32, 95%CI:0.15-0.71, p = 0.004) and postoperative complications (OR = 0.23, 95%CI:0.15-0.34, p < 0.001) were both significantly reduced in the ERAS group, compared with the control group. The ERAS nursing program, when applied to patients undergoing laparoscopic hepatic cancer resection, can effectively reduce the incidence of SSWI and postoperative complications, thus promoting postoperative recovery.
本研究旨在探讨加速康复外科(ERAS)护理方案对接受腹腔镜肝切除术(LH)治疗肝细胞癌患者手术部位伤口感染(SSWI)和术后并发症的影响。通过计算机检索 PubMed、Cochrane 图书馆、Web of Science、Embase、中国知网和万方数据库,收集截至 2023 年 9 月发表的随机对照试验(RCT)。目标研究评估了 ERAS 护理方案在接受 LH 治疗肝细胞癌患者中的效果。两名独立作者筛选文献、提取数据并进行质量评估。二分类变量采用比值比(OR)和 95%置信区间(CI)进行分析,作为效应分析统计量。使用 Stata 软件(版本 17.0)进行数据分析。纳入 11 项 RCT,共 765 例患者,ERAS 组 383 例,对照组 382 例。结果显示,ERAS 组 SSWI 发生率(OR=0.32,95%CI:0.15-0.71,p=0.004)和术后并发症发生率(OR=0.23,95%CI:0.15-0.34,p<0.001)均明显低于对照组。ERAS 护理方案应用于接受腹腔镜肝癌切除术的患者,可有效降低 SSWI 和术后并发症的发生率,促进术后康复。