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髋关节和膝关节置换术后的加速康复:一项关于随机对照试验的系统评价和荟萃分析。

Enhanced recovery after surgery for hip and knee arthroplasty: A systematic review and meta-analysis on randomized control trials.

作者信息

Zhou Wen, Chu Shiying, Zhou Yuan, Huang Yongjing

机构信息

Department of rehabilitation, Wuxi 9th People's Hospital Affiliated to Soochow University, China.

Department of rehabilitation, Wuxi 9th People's Hospital Affiliated to Soochow University, China.

出版信息

Geriatr Nurs. 2024 Nov-Dec;60:249-257. doi: 10.1016/j.gerinurse.2024.08.002. Epub 2024 Sep 21.

Abstract

OBJECTIVES

This review aimed to compare the efficacy and safety of enhanced recovery after surgery (ERAS) versus traditional care in patients who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA).

METHODS

All randomized controlled trials (RCTs) were acquired via a comprehensive search of multiple databases. A meta-analysis was performed using Cochrane Collaboration's RevMan 5.4 software to calculate effect sizes.

RESULTS

This meta-analysis included 850 patients in the ERAS group and 845 patients in the control group (patients who received traditional care). The outcomes suggested no significant difference in operative time, intraoperative blood loss, visual analogue scale, 30-day readmission rate, and mortality rate between the two groups. However, the ERAS group was associated with a significant decrease in transfusion rate, hospital length of stay, and postoperative complications. Moreover, the ERAS group had higher Hospital for Special Surgery scores and satisfaction rates.

CONCLUSIONS

Patients who underwent THA and TKA would benefit more from ERAS than traditional care.

摘要

目的

本综述旨在比较接受全髋关节置换术(THA)和全膝关节置换术(TKA)的患者中,术后加速康复(ERAS)与传统护理的疗效和安全性。

方法

通过全面检索多个数据库获取所有随机对照试验(RCT)。使用Cochrane协作网的RevMan 5.4软件进行荟萃分析以计算效应量。

结果

该荟萃分析纳入了ERAS组的850例患者和对照组(接受传统护理的患者)的845例患者。结果表明,两组在手术时间、术中出血量、视觉模拟评分、30天再入院率和死亡率方面无显著差异。然而,ERAS组的输血率、住院时间和术后并发症显著降低。此外,ERAS组的特殊外科医院评分和满意度更高。

结论

接受THA和TKA的患者从ERAS中获益比传统护理更多。

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