跟腱断裂缝合术后病人实施分阶段康复护理效果的Meta分析

Effect of phased rehabilitation nursing in patients with Achilles tendon rupture and suture surgery:a Meta-analysis

目的:系统评价分阶段康复护理在跟腱断裂缝合术后病人中的应用效果。方法:计算机检索PubMed、the Cochrane Library、EMbase、Web of Science、中国知网(CNKI)、维普数据库(VIP)、万方数据库(WanFang Database)、中国生物医学文献数据库(CBM),纳入有关常规护理对比分阶段康复护理结合常规护理在跟腱断裂缝合术后病人中的应用研究。检索时限为建库至2023年3月28日。按照纳入、排除标准筛选文献,从中提取所需信息,根据Cochrane系统评估手册的偏倚风险评估工具对纳入文献进行偏倚风险评估。采用Review Manager 5.4软件进行统计分析。结果:最终纳入11篇文献。Meta分析结果表明,与常规护理相比,分阶段康复护理能明显改善病人术后疼痛[MD=-2.11,95%CI(-2.56,-1.66),P<0.00001]、缩短住院时间[MD=-4.46,95%CI(-4.90,-4.01),P<0.00001]、降低术后并发症发生率[RR=0.29,95%CI(0.18,0.45),P<0.00001]、切口感染发生率[RR=0.29,95%CI(0.14,0.60),P=0.001]、术后发热发生率[RR=0.35,95%CI(0.15,0.81),P=0.01]、跟腱粘连发生率[RR=0.26,95%CI(0.10,0.69),P=0.007]、提高疗效[RR=1.16,95%CI(1.02,1.33),P=0.03]。但两组术后跟腱再断裂发生率比较,差异无统计学意义[RR=0.33,95%CI(0.05,2.08),P=0.24]。结论:现有证据表明,分阶段康复护理可有效改善跟腱断裂缝合术后病人的康复情况。建议临床积极应用分阶段康复护理,有效促进病人康复。

Objective:To systematically evaluate the effect of phased rehabilitation nursing in patients after Achilles tendon rupture and suture.Methods:Studies on the application of conventional nursing and phased rehabilitation nursing combined with conventional nursing in patients after Achilles tendon rupture and suturing were reviewed from PubMed,the Cochrane library,EMbase,Web of Science,CNKI,VIP,WanFang Database,CBM.The retrieval deadline was from the establishment of each data database until March 28,2023.The documents were included according to inclusion and exclusion criteria,and the required information was extracted from them.The included literature was assessed for risk of bias according to the risk of Bias assessment tool of the Cochrane Manual of Systematic Review.Review Manager 5.4 was used for statistical analysis.Results:A total of 11 articles were included.The results of Meta-analysis showed that compared with conventional nursing,phased rehabilitation nursing could significantly improve postoperative pain(MD=-2.11,95%CI-2.56--1.66,P<0.00001),shorten hospital stay(MD=-4.46,95%CI-4.90--4.01,P<0.00001),reduce the incidence of postoperative complications(RR=0.29,95%CI 0.18-0.45,P<0.00001),incision infection(RR=0.29,95%CI 0.14-0.60,P=0.001),fever(RR=0.35,95%CI 0.15-0.81,P=0.01),and Achilles tendon adhesion(RR=0.26,95%CI 0.10-0.69,P=0.007),and improve curative effect(RR=1.16,95%CI 1.02-1.33,P=0.03).However,there were no significant difference in the incidence of postoperative Achilles tendon re-rupture between the two groups(RR=0.33,95%CI 0.05-2.08,P=0.24).Conclusion:The existing evidence shows that phased rehabilitation nursing can effectively improve the rehabilitation of patients after Achilles tendon rupture and suture.It is suggested to actively apply phased rehabilitation nursing in clinic to effectively promote the rehabilitation of patients.