加速康复护理对降低国内儿童日间手术术后并发症的有效性meta分析

Meta-analysis of the effectiveness of enhanced recovery after surgery nursing in reducing postoperative complications of day surgery in children

目的 通过检索国内文献,系统评价加速康复护理对降低儿童日间手术术后并发症的影响。方法 检索PubMed、中国知网、万方等数据库中与儿童日间手术模式下加速康复护理相关的文献,文献检索从建库至2022年6月。对获取的全文及其参考文献进行仔细阅读评判,确定纳入的研究,提取数据后采用RevMan5.3进行meta分析。结果 纳入的6项研究共包含2 059例病例,其中加速康复护理979例,常规护理1 080例。对比其术后并发症,不同护理模式在术后苏醒时间[比值比(OR)=-8.62,95%可信区间(95%CI)-9.50~-7.73,P<0.000 01]、术后恶心呕吐发生率(OR=0.26,95%CI 0.14~0.48,P<0.000 01)及发热发生率(OR=0.47,95%CI 0.25~0.91,P=0.02)方面存在显著统计学差异。结论 加速康复护理在儿童日间手术中的应用对患儿术后早期复苏,降低术后恶心呕吐、发热的发生率有显著优势。

Objective To systematically evaluate the effect of accelerated rehabilitation nursing on reducing postoperative complications in children undergoing day surgery by searching domestic literature.Methods PubMed,CNKI,Wanfang and other databases were searched for literatures related to accelerated rehabilitation nursing in children′s day surgery mode from the establishment of the database to June 2022.The full text and its references were carefully read and judged to determine the included studies.After extracting the data,RevMan5.3 was used for meta-analysis.Results A total of 2059 cases were included in the six studies,including 979 cases of accelerated rehabilitation nursing and 1080 cases of routine nursing.Compared with the postoperative complications,there were significant differences in the postoperative recovery time[odds ratio(OR)=-8.62,95%CI-9.50--7.73,P<0.00001],the incidence of postoperative nausea and vomiting(OR=0.26,95%CI 0.14-0.48,P<0.00001)and fever(OR=0.47,95%CI 0.25-0.91,P=0.02).Conclusion The application of accelerated rehabilitation nursing in children′s day surgery has significant advantages in early postoperative recovery,reducing the incidence of postoperative nausea and vomiting and postoperative fever.