ERAS理念对我国手术患者焦虑、抑郁影响的Meta分析

Meta-analysis of the impact of ERAS concept on anxiety and depression in surgical

目的明确加速康复外科(enhenced recovery after surgery,ERAS)理念对我国手术患者焦虑、抑郁的影响。方法计算机检索中国知网(CNKI)、万方数据库(Wanfang Data)、中国生物医学文献数据库(CMB)、中国维普全文数据库(VIP)、Pub Med、Web of Science、Cochrane Library、Embase、CINAHL等数据库关于ERAS对患者抑郁、焦虑影响的相关文献。按照纳排标准筛选文献并评价纳入研究的质量后,采用RevMan 5.4软件进行Meta分析。结果共纳入12篇文献,总体质量中等。研究总样本量为1803例,其中观察组患者849例,对照组患者954例,年龄28.8~76.9岁,涵盖8个省份的手术人群。Meta分析结果提示:ERAS对患者焦虑的总体影响为观察组优于对照组,合并相关系数及95%CI为-1.56(-2.28,-0.85);ERAS对患者抑郁的总体影响为观察组优于对照组,合并相关系数及95%CI为-1.55(-2.59,-0.50);根据专科研究领域、患者地区分布、心理评价工具进行亚组分析,结果均提示ERAS对患者焦虑、抑郁影响观察组效果优于对照组。结论ERAS理念可以改善我国接受手术治疗患者焦虑、抑郁状态,值得医护人员关注并在临床应用。

Objective To clarify the impact of the concept of accelerated recovery after surgery(ERAS)on anxiety and depression in surgical patients in China.Methods Computer retrieval of related literature was conducted on databases such as CNKI,Wanfang Data,CMB,VIP,Pub Med,Web of Science,Cochrane Library,Embase,CINAHL,etc.to investigate the impact of ERAS on depression and anxiety in patients.After screening the literature according to the inclusion criteria and evaluating the quality of the study,Meta-analysis was conducted using RevMan 5.4 software.Results A total of 12 articles were included,with an overall average quality.The total sample size of the study was 1803,including 849 patients in the observation group and 954 patients in the control group,aged 28.8-76.9 years,covering the surgical population in 8 provinces.The Meta-analysis results suggested that the overall impact of ERAS on anxiety in patient was better in the observation group than in the control group,with a combined correlation coefficient and 95%CI of-1.56(-2.28,-0.85);The overall impact of ERAS on depression in patients was better in the observation group than in the control group,with a combined correlation coefficient and 95%CI of-1.55(-2.59,-0.50);Subgroup analysis was conducted based on specialized research fields,patient regional distribution,and psychological evaluation tools,and the results showed that ERAS had a better effect on anxiety and depression in patients in the observation group than in the control group.Conclusion The ERAS concept can improve the anxiety and depression status of patients undergoing surgical treatment in China,which is worthy of attention and clinical application by medical staff.