快速康复外科护理对跟骨骨折患者术后疼痛疗效的meta分析

Meta-analysis of the nursing efficacy of enhanced recovery after surgery on postoperative pain in patients with calcaneal fractures

目的系统评价基于快速康复外科护理对跟骨骨折患者术后疼痛的影响效果。方法通过计算机检索CBM、CNKI、万方、维普、PubMed、Web of Science、Cochrane Library、Embase中所有涉及快速康复外科护理对跟骨骨折患者术后疼痛的随机对照研究,检索时限均为建库至2021年9月。由两名研究者独立筛选文献、质量评价和数据提取,采用Rev Man 5.3软件对结果进行meta分析。结果共纳入13篇文献,共1056例患者。meta分析结果显示:基于快速康复外科的护理组术后1 d[MD=-2.54,95%CI(-3.29,-1.80),P<0.00001]、术后2 d[MD=-1.73,95%CI(-2.10,-1.35),P<0.00001]和术后3 d[MD=-1.70,95%CI(-1.81,-1.60),P<0.00001]的疼痛评分均低于常规护理,差异有统计学意义。结论基于快速康复外科的护理组能有效改善跟骨骨折患者术后疼痛,促进患者早期康复。

Objective To systematically evaluate the nursing efficacy based on enhanced recovery after surgery(ERAS)on postoperative pain in patients with calcaneal fractures.Methods All randomized controlled research literature involving ERAS-based nursing on postoperative pain in patients with calcaneal fractures in CBM,CNKI,Wanfang,VIP,PubMed,Web of Science,Cochrane Library and Embase were retrieved through computer.And the retrieval time limits were all from the establishment of the databases to September 2021.After independent literature screening,quality evaluation and data extraction,the two researchers then conducted meta-analysis on the results with Rev Man 5.3 softwar e.Results A total of 13 articles were included,with a total of 1056 patients.The results of meta-analysis showed that the pain scores of the nursing group based on ERAS were all lower than those of the conventional nursing group at 1 d(MD=-2.54,95%CI[-3.29,-1.80],P<0.00001),2 d(MD=-1.73,95%CI[2.10,-1.35],P<0.00001)and 3 d(MD=-1.70,95%CI[-1.81,-1.60],P<0.00001)after operation,with statistically significant differences.Conclusion The nursing based on ERAS can effectively improve the postoperative pain in patients with calcaneal fractures and promote their early rehabilitation.