早期下床活动对肝切除术后患者康复效果影响的Meta分析

Effects of early ambulation on rehabilitation of patients after hepatectomy:a Meta-analysis

目的系统评价早期下床活动对肝切除术后患者康复效果的影响。方法计算机检索CNKI、万方数据库、维普数据库、生物医学文献数据库、Ovid、PubMed、Web of Science、Embase、Cochrane Library等中英文数据库中有关早期下床活动对肝切除术后患者康复效果影响的RCT文献,检索时间为建库至2020年5月10日,采用RevMan 5.3软件对符合纳入标准的文献进行Meta分析。结果共纳入RCT文章8篇,合计样本量936例,其中干预组(早期下床活动方案)474例、对照组(常规活动护理)462例。系统评价结果显示:与对照组患者相比,干预组患者的术后首次排气时间[加权均数差值(WMD)为-21.01,95%置信区间(CI)为(-25.98,-16.04),P<0.05]和首次排便时间[WMD=-31.97,95%CI(-54.69,-9.25),P<0.05]均缩短,术后胃肠不适[相对危险度(RR)为0.44,95%CI(0.34,0.56),P<0.05]和并发症[RR=0.76,95%CI(0.56,1.02),P<0.05]发生率均下降,首次下床活动时间[WMD=-20.64,95%CI(-21.71,-19.56),P<0.05]更早,差异均具有统计学意义。结论对肝切除术后患者实施早期下床活动是安全有效的,有利于患者胃肠功能恢复,减少胃肠不适并发症的发生,促进患者康复。

Objective To systematically evaluate the effect of early ambulation on the rehabilitation of patients after hepatectomy.Methods Computer was used to search randomized controlled trial(RCT)literature on the effect of early ambulation on the rehabilitation of patients after hepatectomy in Chinese and English databases,such as China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP,China Biology Medicine,Ovid,PubMed,Web of Science,Embase,Cochrane Library.The retrieval time was from the establishment of database to May 10,2020.RevMan 5.3 software was used to conduct Meta-analysis on literature that met the inclusion criteria.Results A total of 8 RCT articles were included,with a total sample size of 936 cases,including 474 cases in intervention group(early ambulation)and 462 cases in control group(routine activity care).The results of the systematic review showed that compared with control group,intervention group shorted the first exhaust time[weighted mean difference(WMD)=-21.01,95%confidence interval(CI)(-25.98,-16.04),P<0.05]and first defecation time[WMD=-31.97,95%CI(-54.69,-9.25),P<0.05]after surgery,decreased gastrointestinal discomfort[relative risk(RR)=0.44,95%CI(0.34,0.56),P<0.05]and complications[RR=0.76,95%CI(0.56,1.02),P<0.05]after surgery,and had earlier time to early ambulation[WMD=-20.64,95%CI(-21.71,-19.56),P<0.05],the differences were statistically significant.Conclusions It is safe and effective to implement early ambulation in patients after hepatectomy,which is beneficial to the recovery of gastrointestinal function of patients,reduces the occurrence of gastrointestinal discomfort and complications,and promotes the recovery of patients.