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加速康复外科在老年髋膝关节置换术围手术期护理中的应用:系统评价和荟萃分析。

Application of enhanced recovery after surgery in perioperative nursing care of elderly patients with hip and knee arthroplasty: A systematic review and meta-analysis.

机构信息

Department of Orthopedics, Jiujiang First People's Hospital, Jiujiang City, China.

出版信息

Medicine (Baltimore). 2024 Mar 1;103(9):e37240. doi: 10.1097/MD.0000000000037240.

Abstract

BACKGROUND

To collect data from randomized controlled trials (RCTs) to evaluate the effects of enhanced recovery after surgery on postoperative recovery of elderly patients who underwent hip or knee arthroplasty.

METHODS

The search was limited to studies published prior to January 1, 2023, in the electronic databases of Cochrane, Embase, Ovid Medline, Proquest, PubMed, Scopus, Web of Science, and Chinese databases, including China National Knowledge Internet (CNKI) and SinoMed. All relevant data were collected from the studies that met the inclusion criteria. The outcome variables were recovery of joint function and incidence of complications. STATA software (version 14.0) was used for the meta-analysis.

RESULTS

A total of 44 published studies met the inclusion criteria. The cumulative data included 2203 cases receiving enhanced recovery after surgery (ERAS), and 2173 cases receiving traditional recovery after surgery (non-ERAS). The meta-analysis showed that the VAS score was significantly lower in the ERAS group than in the non-ERAS group (P < .01), and there were fewer incidences of complications in the ERAS group than in the control group (P < .01).

CONCLUSIONS

ERAS significantly reduced pain and the incidence of complications in elderly patients who had undergone joint replacement surgery.

摘要

背景

收集随机对照试验(RCT)的数据,以评估术后康复增强策略对接受髋关节或膝关节置换术的老年患者术后恢复的影响。

方法

检索范围限于 2023 年 1 月 1 日之前在 Cochrane、Embase、Ovid Medline、Proquest、PubMed、Scopus、Web of Science 和中国数据库(包括中国知识资源总库(CNKI)和中国生物医学文献数据库(SinoMed))中的电子数据库发表的研究。纳入符合标准的研究中所有相关数据。结局变量为关节功能恢复和并发症发生率。采用 STATA 软件(版本 14.0)进行荟萃分析。

结果

共有 44 项已发表的研究符合纳入标准。累积数据包括 2203 例接受术后康复增强策略(ERAS)的患者,和 2173 例接受传统术后康复策略(非-ERAS)的患者。荟萃分析显示,ERAS 组的 VAS 评分明显低于非-ERAS 组(P<0.01),ERAS 组的并发症发生率低于对照组(P<0.01)。

结论

ERAS 可显著减轻接受关节置换手术的老年患者的疼痛和并发症发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1538/10906613/b5bd49e4d943/medi-103-e37240-g001.jpg

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