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快速康复护理对改善结直肠癌术后患者临床结局的影响。

Effect of rapid rehabilitation nursing on improving clinical outcomes in postoperative patients with colorectal cancer.

作者信息

Song Jing-Yan, Cao Jing, Mao Jian, Wang Jiang-Lian

机构信息

Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.

Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.

出版信息

World J Gastrointest Surg. 2024 Jul 27;16(7):2119-2126. doi: 10.4240/wjgs.v16.i7.2119.

Abstract

BACKGROUND

Surgical resection is the cornerstone treatment for colorectal cancer. Rapid rehabilitation care predicated on evidence-based medical theory aims to improve postoperative nursing care, subsequently reducing the physical and mental traumatic stress response and helping patients who undergo surgery recover rapidly.

AIM

To assess the effect of rapid rehabilitation care on clinical outcomes, including overall postoperative complications, anastomotic leaks, wound infections, and intestinal obstruction in patients with colorectal cancer.

METHODS

We searched the PubMed, Web of Science, Embase, Elsevier Science Direct, and Springer Link databases from January 1, 2010, to January 1, 2024, to screen eligible studies on rapid rehabilitation care among patients who underwent colorectal cancer surgery. Patients were screened based on the inclusion and exclusion criteria. RevMan 5.4 software was used for statistical analysis of the data.

RESULTS

Twelve studies were enrolled, which included 2420 patients. The results showed that rapid rehabilitation care decreased the incidence of overall postoperative complications (OR: 0.44, 95%CI: 0.26-0.74, = 0.002), anastomotic leaks (OR: 0.68, 95%CI: 0.41-1.12, = 0.13), wound infections (OR: 0.45, 95%CI: 0.29-0.72, = 0.0007), and intestinal obstruction (OR: 0.54, 95%CI: 0.34-0.86, = 0.01) compared to conventional care. Further trials and studies are needed to confirm these results.

CONCLUSION

Rapid rehabilitation care decreased the occurrence of postoperative complications, anastomotic leaks, wound infections, and intestinal obstruction compared to conventional care in patients who underwent colorectal surgery. Therefore, promoting the application of rapid rehabilitation care in clinical practice cannot be overemphasized.

摘要

背景

手术切除是结直肠癌的基石性治疗方法。基于循证医学理论的快速康复护理旨在改善术后护理,进而减轻身心创伤应激反应,帮助手术患者快速康复。

目的

评估快速康复护理对结直肠癌患者临床结局的影响,包括术后总体并发症、吻合口漏、伤口感染和肠梗阻。

方法

我们检索了2010年1月1日至2024年1月1日期间的PubMed、Web of Science、Embase、Elsevier Science Direct和Springer Link数据库,以筛选接受结直肠癌手术患者的快速康复护理相关合格研究。根据纳入和排除标准对患者进行筛选。使用RevMan 5.4软件对数据进行统计分析。

结果

共纳入12项研究,包括2420例患者。结果显示,与传统护理相比,快速康复护理降低了术后总体并发症(比值比:0.44,95%置信区间:0.26 - 0.74,P = 0.002)、吻合口漏(比值比:0.68,95%置信区间:0.41 - 1.12,P = 0.13)、伤口感染(比值比:0.45,95%置信区间:0.29 - 0.72,P = 0.0007)和肠梗阻(比值比:0.54,95%置信区间:0.34 - 0.86,P = 0.01)的发生率。需要进一步试验和研究来证实这些结果。

结论

与传统护理相比,快速康复护理降低了结直肠癌手术患者术后并发症、吻合口漏、伤口感染和肠梗阻的发生率。因此,在临床实践中推广快速康复护理的应用再怎么强调都不为过。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2380/11287703/bf7374a64f51/WJGS-16-2119-g001.jpg

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