快速康复护理在结直肠癌围手术期应用效果的Meta分析

Meta-analysis of the effect of fast track surgery in the perioperative period of colorectal cancer

目的系统评价快速康复护理在结直肠癌围手术期的应用效果,以探索更有效和科学的护理决策。方法计算机检索PubMed、中国知网全文数据库(CNKI)、维普网(VIP)、万方数据库中关于快速康复护理在结直肠癌围手术期患者中的临床随机对照试验(RCT),筛选出符合纳入标准的文献,进行文献质量评价和提取,采用RevMan 5.3软件对纳入文献进行Meta分析。结果共纳入15篇RCT,合计1368例患者,观察组686例,对照组682例。Meta分析结果显示,与对照组相比,快速康复护理组能有效降低患者首次排气时间、首次排便时间、首次下床活动时间及并发症的发生率、住院时长、住院费用,差异均有统计学意义(P<0.05)。结论对于结直肠癌围手术期患者进行快速康复护理可有效提高患者的生存质量,在一定程度上降低并发症发生率、减轻患者家庭经济负担,但由于纳入文献质量不高和偏倚因素影响及Meta分析的自身局限性,研究结果还需更多大样本、高质量RCT进一步验证。

Objective To systematically evaluate the application effect of fast track surgery in the perioperative period of colorectal cancer,and to explore more effective and scientific nursing decision-making.Methods PubMed,CNKI,VIP and Wanfang databases were searched by computer for clinical randomized controlled trials(RCTs)of fast track surgery in patients with colorectal cancer during perioperative period.Literatures that met the inclusion criteria were screened out,and literature quality was evaluated and extracted.Meta-analysis was carried out with RevMan 5.3 software.Results A total of 15 RCTs were included in 1368 patients,686 in the observation group and 682 in the control group.Meta-analysis showed that compared with the control group,the fast track surgery group could effectively reduce the first exhaust time,first defecation time,first out-of-bed activity time and the incidence of complications,hospitalization time,hospitalization costs,and the difference was statistically significant(P<0.05).Conclusion Fast track surgery for patients undergoing colorectal perioperative period can effectively improve their quality of life,reduce the incidence of complications and reduce family financial burden to a certain extent.However,due to the influence of poor quality of literature and bias factors and the limitations of meta-analysis,the results of the study need to be further validated by large samples and high-quality RCT.