目的评价运动干预对造血干细胞移植(HSCT)患者疲乏的影响。方法检索Cochrane library、PubMed、Web of Science、Embase、CINAHL、中国知网(CNKI)、万方(Wanfang Data)、维普(VIP)、中国生物医学文献数据库(CBM)中HSCT患者运动干预的随...目的评价运动干预对造血干细胞移植(HSCT)患者疲乏的影响。方法检索Cochrane library、PubMed、Web of Science、Embase、CINAHL、中国知网(CNKI)、万方(Wanfang Data)、维普(VIP)、中国生物医学文献数据库(CBM)中HSCT患者运动干预的随机对照试验,检索时限为建库至2024年2月。采用RevMan 5.3软件进行Meta分析。结果共纳入6篇文献,Meta分析结果显示,试验组与对照组的疲乏得分差异有统计学意义[SMD=-0.24,95%CI(-0.44,-0.03),P<0.001]。亚组分析,运动干预能够改善异基因HSCT患者的疲乏[SMD=-0.58,95%CI(-0.80,-0.35),P<0.001];贯穿整个移植期[SMD=-0.58,95%CI(-0.80,-0.35),P<0.001]、超过12周的运动干预[SMD=-0.53,95%CI(-0.78,-0.29),P<0.001]能减轻患者的疲乏。结论运动干预能够改善HSCT患者的疲乏,需注意运动的强度、时长及个体化。未来需要高质量、大样本、多人群的研究进一步验证其干预效果。展开更多
目的系统评价决奈达隆用于预防心房颤动(AF)消融术早期复发的疗效及安全性。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、CNKI、WanFang Data和VIP数据库,搜集决奈达隆预防AF消融术后早期复发疗效及安全性的临床...目的系统评价决奈达隆用于预防心房颤动(AF)消融术早期复发的疗效及安全性。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、CNKI、WanFang Data和VIP数据库,搜集决奈达隆预防AF消融术后早期复发疗效及安全性的临床研究。检索时限均从建库至2024年4月16日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果最终纳入11项研究,其中3项随机对照试验和8项队列研究,包括1534例患者。Meta分析结果显示,决奈达隆组与胺碘酮组消融术后AF早期复发率差异无统计学意义[RR=1.15,95%CI(0.90,1.47),P=0.25];与胺碘酮组相比,决奈达隆组出血发生率[RR=2.28,95%CI(1.08,4.81),P<0.05]和消化道反应发生率[RR=3.87,95%CI(1.39,10.74),P=0.009]均较高,而甲状腺功能异常发生率较低[RR=0.15,95%CI(0.06,0.40),P<0.001],两组消融术后心动过缓发生率、肝肾功能异常发生率及总的药品不良反应发生率差异均无统计学意义(P>0.05)。与普罗帕酮组相比,决奈达隆组消融术后AF早期复发率较低[RR=0.31,95%CI(0.17,0.57),P<0.001],而两组的不良反应发生率差异无统计学意义(P>0.05)。结论当前证据表明,决奈达隆用于预防AF消融术后早期复发有效性与胺碘酮相当,但比普罗帕酮的疗效更好。在安全性方面,与胺碘酮相比,决奈达隆导致甲状腺功能异常的风险较低,但导致消化道不良反应和出血的风险较高。受纳入研究数量及质量的限制,上述结论尚待更多大样本、多中心、高质量的研究予以验证。展开更多
目的:探索汉防己甲素治疗类风湿关节炎的有效性和安全性。方法:在中国知网、维普网、万方数据、SinoMed、PubMed、Springer、Web of Science、Cochrane Central Register of Controlled Trails数据库中检索汉防己甲素治疗类风湿关节炎...目的:探索汉防己甲素治疗类风湿关节炎的有效性和安全性。方法:在中国知网、维普网、万方数据、SinoMed、PubMed、Springer、Web of Science、Cochrane Central Register of Controlled Trails数据库中检索汉防己甲素治疗类风湿关节炎的随机对照临床试验。采用R 3.5.3软件对有效率、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子、视觉模拟评分(VAS)、疾病活动度评分(DAS)、压痛关节计数(TJC)、肿胀关节计数(SJC)和晨僵持续时间等临床指标,以及不良事件发生率进行meta分析。结果:最终纳入10篇研究。meta分析结果显示,汉防己甲素对治疗的有效率(OR=3.27,95%CI:2.01~5.37,P<0.01)、ESR(SMD=1.12,95%CI:0.06~2.19,P<0.05)、CRP(SMD=0.75,95%CI:0.28~1.22,P<0.01)、VAS(SMD=0.64,95%CI:0.29~1.00,P<0.01)、TJC(SMD=1.16,95%CI:0.58~1.74,P<0.01)、SJC(SMD=0.85,95%CI:0.40~1.31,P<0.01)、晨僵持续时间(SMD=1.09,95%CI:0.68~1.50,P<0.01)有一定的改善作用,对类风湿因子(SMD=1.70,95%CI:-1.10~4.51,P>0.05)和DAS(SMD=0.26,95%CI:-0.59~1.11,P>0.05)的改善与对照组差异无统计学意义。汉防己甲素治疗类风湿关节炎的不良事件总发生率为20%(95%CI:12%~27%,I^(2)=60%,P<0.05),不良事件的程度较轻,患者转归良好。结论:汉防己甲素能提高药物治疗类风湿关节炎的临床效果,且不良事件程度较轻。展开更多
Inflammatory bowel disease,particularly ulcerative colitis(UC),poses significant treatment challenges due to its chronic nature and potential for severe complications.This editorial reviews a recent network meta-analy...Inflammatory bowel disease,particularly ulcerative colitis(UC),poses significant treatment challenges due to its chronic nature and potential for severe complications.This editorial reviews a recent network meta-analysis that evaluated the efficacy of and highlighted the superior outcomes achieved by combining each of five traditional Chinese medicine(TCM)formulations with mesalazine for the adjuvant treatment of UC.Clinical outcomes included enhanced mucosal healing,improved quality of life,and reduced recurrence rates.Additionally,the combination therapy resulted in a lower incidence of adverse reactions compared with mesalazine monotherapy.Despite these promising results,limitations such as variability in study quality and TCM dosage highlight the need for further highquality,large-sample,multicenter randomized controlled trials.This editorial underscores the potential of TCM in enhancing UC management and calls for more rigorous research to substantiate these findings and refine clinical guidelines.展开更多
BACKGROUND Percutaneous hepatobiliary drainage(PTCD)is an effective method for the treatment of biliary obstruction and other diseases,but postoperative complications are still one of the important problems faced by p...BACKGROUND Percutaneous hepatobiliary drainage(PTCD)is an effective method for the treatment of biliary obstruction and other diseases,but postoperative complications are still one of the important problems faced by patients.Continuous nursing is a comprehensive nursing model that plays an important role in postoperative recovery.The purpose of this study was to investigate the effect of continuous nursing on the incidence of complications in patients after PTCD surgery through meta-analysis and to evaluate its efficacy and safety.AIM To evaluate the effect of extended nursing on the incidence of complications in discharged patients after percutaneous transhepatic biliary drainage(PTBD).METHODS Randomized controlled studies on PTBD postdischarge extended care were identified in the CNKI,Wanfang,VIP,CBM,PubMed,Cochrane Library,Embase,Web of Science,and other databases.The quality of the included studies was evaluated using the Joanna Briggs Institute of Australia literature quality evaluation tool,and a meta-analysis of the included studies was performed with RevMan 5.4 software.RESULTS Finally,9 studies were included,with a total sample size of 854 patients(425 patients in the control group and 429 patients in the intervention group).Meta-analysis revealed that extended care effectively reduced biliary tract infection(RR:0.42,95%CI:0.30-0.57),puncture wound infection(RR:0.19,95%CI:0.06-0.65),catheter protrusion or displacement in discharged patients after PTBD(RR:0.31,95%CI:0.18-0.54),catheter blockage(RR:0.23,95%CI:0.13-0.42),skin infection around the drainage tube(RR:0.30,95%CI:0.12-0.77),and catheter-related readmissions(RR:0.34,95%CI:0.18-0.65)(P<0.05).CONCLUSION Compared with conventional discharge care,extended care can effectively reduce the occurrence of complications such as biliary tract infection,puncture wound infection,catheter prolapse or displacement,catheter blockage,skin infection around the drainage tube,and catheter-related readmission in discharged patients after PTBD.展开更多
本研究旨在通过Meta分析探讨饲粮中添加膳食纤维对肉鸡生长性能和肠道健康的影响。通过检索Web of Science、PubMed、中国知网、万方等数据库中2007—2022年关于膳食纤维对肉鸡生长性能和肠道形态影响的试验研究,共筛选到27篇文献,共计5...本研究旨在通过Meta分析探讨饲粮中添加膳食纤维对肉鸡生长性能和肠道健康的影响。通过检索Web of Science、PubMed、中国知网、万方等数据库中2007—2022年关于膳食纤维对肉鸡生长性能和肠道形态影响的试验研究,共筛选到27篇文献,共计5310羽肉鸡。采用Re⁃view Manager 5.3软件对肉鸡平均日增重(ADG)、终末体重(FBW)、平均日采食量(ADFI)、料重比(F/G)和回肠绒毛高度(VH)、隐窝深度(CD)、绒毛高度/隐窝深度(VH/CD)及肌胃相对重量(GRW)进行分析。结果表明:与对照组相比,饲粮中添加膳食纤维显著提高了肉鸡ADG[合并效应值(MD)=1.01,95%置信区间(95%CI)为0.29~1.72,P=0.00600]、FBW(MD=45.05,95%CI为16.68~73.42,P=0.00200)和回肠VH(MD=36.58,95%CI为14.22~58.94,P=0.00100)及GRW(MD=0.16,95%CI为0.11~0.21,P<0.00001);显著降低了肉鸡F/G(MD=-0.04,95%CI为-0.06~-0.01,P=0.00800);而饲粮中添加膳食纤维对肉鸡ADF(MD=0.29,95%CI为-0.59~1.17,P=0.52000)及回肠CD(MD=5.51,95%CI为-1.83~12.86,P=0.14000)、VH/CD(MD=0.06,95%CI为-0.01~0.14,P=0.09000)的影响不显著。亚组分析表明,饲粮中添加不溶性膳食纤维(IDF)可显著提高肉鸡ADG(MD=1.34,95%CI为0.56~2.12,P=0.00070)及回肠VH(MD=50.37,95%CI为24.22~76.51,P=0.00020)、VH/CD(MD=0.25,95%CI为0.17~0.32,P<0.00001),显著降低了F/G(MD=-0.04,95%CI为-0.06~-0.02,P=0.00060);饲粮中添加可溶性膳食纤维(SDF)对肉鸡ADFI(MD=0.71,95%CI为-0.68~2.10,P=0.32000)、ADG(MD=0.69,95%CI为-0.65~2.03,P=0.31000]、F/G(MD=-0.04,95%CI为-0.09~0.01,P=0.09000)及回肠VH(MD=17.00,95%CI为-5.51~39.50,P=0.14000]、CD(MD=3.01,95%CI为-3.10~9.13,P=0.33000)、VH/CD(MD=-0.27,95%CI为-0.79~0.29,P=0.36000)的影响不显著。由此可见,肉鸡饲粮粗纤维含量在1.43%~6.17%时,添加膳食纤维具有改善肉鸡生长性能和肠道健康的作用。与SDF相比,IDF具有更好的提高肉鸡生长性能和肠道健康的作用。展开更多
BACKGROUND Explore the risk factors of gastrointestinal dysfunction after gastrointestinal tumor surgery and to provide evidence for the prevention and intervention of gastrointestinal dysfunction in patients with gas...BACKGROUND Explore the risk factors of gastrointestinal dysfunction after gastrointestinal tumor surgery and to provide evidence for the prevention and intervention of gastrointestinal dysfunction in patients with gastrointestinal tumor surgery.AIM To investigate the potential risk factors for gastrointestinal dysfunction following gastrointestinal tumor surgery and to present information supporting the prevention and management of gastrointestinal dysfunction in surgery patients.METHODS Systematically searched the relevant literature from PubMed,Web of Science,Cochrane Library,Embase,CNKI,China Biomedical Database,Wanfang Database,and Weipu Chinese Journal Database self-established until October 1,2022.Review Manager 5.3 software was used for meta-analysis after two researchers independently screened literature,extracted data,and evaluated the risk of bias in the included studies.RESULTS A total of 23 pieces of literature were included,the quality of which was medium or above,and the total sample size was 43878.The results of meta-analysis showed that the patients were male(OR=1.58,95%CI:1.25-2.01,P=0.002)and≥60 years old(OR=2.60,95%CI:1.76-2.87,P<0.001),physical index≥25.3 kg/m2(OR=1.6,95%CI:1.00-1.12,P=0.040),smoking history(OR=1.89,95%CI:1.31-2.73,P<0.001),chronic obstructive pulmonary disease(OR=1.49,95%CI:1.22-1.83,P<0.001),enterostomy(OR=1.47,95%CI:1.26-1.70,P<0.001),history of abdominal surgery(OR=2.90,95%CI:1.67-5.03,P<0.001),surgical site(OR=1.2,95%CI:1.40-2.62,P<0.001),operation method(OR=1.68,95%CI:1.08-2.62,P=0.020),operation duration(OR=2.65,95%CI:1.92-3.67,P<0.001),abdominal adhesion grade(OR=2.52,95%CI:1.90-3.56,P<0.001),postoperative opioid history(OR=5.35,95%CI:3.29-8.71,P<0.001),tumor TNM staging(OR=2.58,95%CI:1.84-3.62,P<0.001),postoperative blood transfusion(OR=2.92,95%CI:0.88-9.73,P=0.010)is a risk factor for postoperative gastrointestinal dysfunction in patients with gastrointestinal tumors.CONCLUSION There are many factors affecting gastrointestinal dysfunction in gastrointestinal patients after surgery.Clinical staff should identify relevant risk factors early and implement targeted intervention measures on the basis of personalized assessment to improve the clinical prognosis of patients.展开更多
BACKGROUND Acute cholecystitis(AC)is a common disease in general surgery.Laparoscopic cholecystectomy(LC)is widely recognized as the"gold standard"surgical procedure for treating AC.For low-risk patients wit...BACKGROUND Acute cholecystitis(AC)is a common disease in general surgery.Laparoscopic cholecystectomy(LC)is widely recognized as the"gold standard"surgical procedure for treating AC.For low-risk patients without complications,LC is the recommended treatment plan,but there is still controversy regarding the treatment strategy for moderate AC patients,which relies more on the surgeon's experience and the medical platform of the visiting unit.Percutaneous transhepatic gallbladder puncture drainage(PTGBD)can effectively alleviate gallbladder inflammation,reduce gallbladder wall edema and adhesion around the gallbladder,and create a"time window"for elective surgery.AIM To compare the clinical efficacy and safety of LC or PTGBD combined with LC for treating AC patients,providing a theoretical basis for choosing reasonable surgical methods for AC patients.METHODS In this study,we conducted a clinical investigation regarding the combined use of PTGBD tubes for the treatment of gastric cancer patients with AC.We performed searches in the following databases:PubMed,Web of Science,EMBASE,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Database.The search encompassed literature published from the inception of these databases to the present.Subsequently,relevant data were extracted,and a meta-analysis was conducted using RevMan 5.3 software.RESULTS A comprehensive analysis was conducted,encompassing 24 studies involving a total of 2564 patients.These patients were categorized into two groups:1371 in the LC group and 1193 in the PTGBD+LC group.The outcomes of the meta-analysis revealed noteworthy disparities between the PTGBD+LC group and the LC group in multiple dimensions:(1)Operative time:Mean difference(MD)=17.51,95%CI:9.53-25.49,P<0.01;(2)Conversion to open surgery rate:Odds ratio(OR)=2.95,95%CI:1.90-4.58,P<0.01;(3)Intraoperative bleeding loss:MD=32.27,95%CI:23.03-41.50,P<0.01;(4)Postoperative hospital stay:MD=1.44,95%CI:0.14-2.73,P=0.03;(5)Overall postoperative compli-cation rate:OR=1.88,95%CI:1.45-2.43,P<0.01;(6)Bile duct injury:OR=2.17,95%CI:1.30-3.64,P=0.003;(7)Intra-abdominal hemorrhage:OR=2.45,95%CI:1.06-5.64,P=0.004;and(8)Wound infection:OR=0.These find-ings consistently favored the PTGBD+LC group over the LC group.There were no significant differences in the total duration of hospitalization[MD=-1.85,95%CI:-4.86-1.16,P=0.23]or bile leakage[OR=1.33,95%CI:0.81-2.18,P=0.26]between the two groups.CONCLUSION The combination of PTGBD tubes with LC for AC treatment demonstrated superior clinical efficacy and enhanced safety,suggesting its broader application value in clinical practice.展开更多
文摘目的:探索汉防己甲素治疗类风湿关节炎的有效性和安全性。方法:在中国知网、维普网、万方数据、SinoMed、PubMed、Springer、Web of Science、Cochrane Central Register of Controlled Trails数据库中检索汉防己甲素治疗类风湿关节炎的随机对照临床试验。采用R 3.5.3软件对有效率、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子、视觉模拟评分(VAS)、疾病活动度评分(DAS)、压痛关节计数(TJC)、肿胀关节计数(SJC)和晨僵持续时间等临床指标,以及不良事件发生率进行meta分析。结果:最终纳入10篇研究。meta分析结果显示,汉防己甲素对治疗的有效率(OR=3.27,95%CI:2.01~5.37,P<0.01)、ESR(SMD=1.12,95%CI:0.06~2.19,P<0.05)、CRP(SMD=0.75,95%CI:0.28~1.22,P<0.01)、VAS(SMD=0.64,95%CI:0.29~1.00,P<0.01)、TJC(SMD=1.16,95%CI:0.58~1.74,P<0.01)、SJC(SMD=0.85,95%CI:0.40~1.31,P<0.01)、晨僵持续时间(SMD=1.09,95%CI:0.68~1.50,P<0.01)有一定的改善作用,对类风湿因子(SMD=1.70,95%CI:-1.10~4.51,P>0.05)和DAS(SMD=0.26,95%CI:-0.59~1.11,P>0.05)的改善与对照组差异无统计学意义。汉防己甲素治疗类风湿关节炎的不良事件总发生率为20%(95%CI:12%~27%,I^(2)=60%,P<0.05),不良事件的程度较轻,患者转归良好。结论:汉防己甲素能提高药物治疗类风湿关节炎的临床效果,且不良事件程度较轻。
文摘Inflammatory bowel disease,particularly ulcerative colitis(UC),poses significant treatment challenges due to its chronic nature and potential for severe complications.This editorial reviews a recent network meta-analysis that evaluated the efficacy of and highlighted the superior outcomes achieved by combining each of five traditional Chinese medicine(TCM)formulations with mesalazine for the adjuvant treatment of UC.Clinical outcomes included enhanced mucosal healing,improved quality of life,and reduced recurrence rates.Additionally,the combination therapy resulted in a lower incidence of adverse reactions compared with mesalazine monotherapy.Despite these promising results,limitations such as variability in study quality and TCM dosage highlight the need for further highquality,large-sample,multicenter randomized controlled trials.This editorial underscores the potential of TCM in enhancing UC management and calls for more rigorous research to substantiate these findings and refine clinical guidelines.
文摘BACKGROUND Percutaneous hepatobiliary drainage(PTCD)is an effective method for the treatment of biliary obstruction and other diseases,but postoperative complications are still one of the important problems faced by patients.Continuous nursing is a comprehensive nursing model that plays an important role in postoperative recovery.The purpose of this study was to investigate the effect of continuous nursing on the incidence of complications in patients after PTCD surgery through meta-analysis and to evaluate its efficacy and safety.AIM To evaluate the effect of extended nursing on the incidence of complications in discharged patients after percutaneous transhepatic biliary drainage(PTBD).METHODS Randomized controlled studies on PTBD postdischarge extended care were identified in the CNKI,Wanfang,VIP,CBM,PubMed,Cochrane Library,Embase,Web of Science,and other databases.The quality of the included studies was evaluated using the Joanna Briggs Institute of Australia literature quality evaluation tool,and a meta-analysis of the included studies was performed with RevMan 5.4 software.RESULTS Finally,9 studies were included,with a total sample size of 854 patients(425 patients in the control group and 429 patients in the intervention group).Meta-analysis revealed that extended care effectively reduced biliary tract infection(RR:0.42,95%CI:0.30-0.57),puncture wound infection(RR:0.19,95%CI:0.06-0.65),catheter protrusion or displacement in discharged patients after PTBD(RR:0.31,95%CI:0.18-0.54),catheter blockage(RR:0.23,95%CI:0.13-0.42),skin infection around the drainage tube(RR:0.30,95%CI:0.12-0.77),and catheter-related readmissions(RR:0.34,95%CI:0.18-0.65)(P<0.05).CONCLUSION Compared with conventional discharge care,extended care can effectively reduce the occurrence of complications such as biliary tract infection,puncture wound infection,catheter prolapse or displacement,catheter blockage,skin infection around the drainage tube,and catheter-related readmission in discharged patients after PTBD.
文摘本研究旨在通过Meta分析探讨饲粮中添加膳食纤维对肉鸡生长性能和肠道健康的影响。通过检索Web of Science、PubMed、中国知网、万方等数据库中2007—2022年关于膳食纤维对肉鸡生长性能和肠道形态影响的试验研究,共筛选到27篇文献,共计5310羽肉鸡。采用Re⁃view Manager 5.3软件对肉鸡平均日增重(ADG)、终末体重(FBW)、平均日采食量(ADFI)、料重比(F/G)和回肠绒毛高度(VH)、隐窝深度(CD)、绒毛高度/隐窝深度(VH/CD)及肌胃相对重量(GRW)进行分析。结果表明:与对照组相比,饲粮中添加膳食纤维显著提高了肉鸡ADG[合并效应值(MD)=1.01,95%置信区间(95%CI)为0.29~1.72,P=0.00600]、FBW(MD=45.05,95%CI为16.68~73.42,P=0.00200)和回肠VH(MD=36.58,95%CI为14.22~58.94,P=0.00100)及GRW(MD=0.16,95%CI为0.11~0.21,P<0.00001);显著降低了肉鸡F/G(MD=-0.04,95%CI为-0.06~-0.01,P=0.00800);而饲粮中添加膳食纤维对肉鸡ADF(MD=0.29,95%CI为-0.59~1.17,P=0.52000)及回肠CD(MD=5.51,95%CI为-1.83~12.86,P=0.14000)、VH/CD(MD=0.06,95%CI为-0.01~0.14,P=0.09000)的影响不显著。亚组分析表明,饲粮中添加不溶性膳食纤维(IDF)可显著提高肉鸡ADG(MD=1.34,95%CI为0.56~2.12,P=0.00070)及回肠VH(MD=50.37,95%CI为24.22~76.51,P=0.00020)、VH/CD(MD=0.25,95%CI为0.17~0.32,P<0.00001),显著降低了F/G(MD=-0.04,95%CI为-0.06~-0.02,P=0.00060);饲粮中添加可溶性膳食纤维(SDF)对肉鸡ADFI(MD=0.71,95%CI为-0.68~2.10,P=0.32000)、ADG(MD=0.69,95%CI为-0.65~2.03,P=0.31000]、F/G(MD=-0.04,95%CI为-0.09~0.01,P=0.09000)及回肠VH(MD=17.00,95%CI为-5.51~39.50,P=0.14000]、CD(MD=3.01,95%CI为-3.10~9.13,P=0.33000)、VH/CD(MD=-0.27,95%CI为-0.79~0.29,P=0.36000)的影响不显著。由此可见,肉鸡饲粮粗纤维含量在1.43%~6.17%时,添加膳食纤维具有改善肉鸡生长性能和肠道健康的作用。与SDF相比,IDF具有更好的提高肉鸡生长性能和肠道健康的作用。
文摘BACKGROUND Explore the risk factors of gastrointestinal dysfunction after gastrointestinal tumor surgery and to provide evidence for the prevention and intervention of gastrointestinal dysfunction in patients with gastrointestinal tumor surgery.AIM To investigate the potential risk factors for gastrointestinal dysfunction following gastrointestinal tumor surgery and to present information supporting the prevention and management of gastrointestinal dysfunction in surgery patients.METHODS Systematically searched the relevant literature from PubMed,Web of Science,Cochrane Library,Embase,CNKI,China Biomedical Database,Wanfang Database,and Weipu Chinese Journal Database self-established until October 1,2022.Review Manager 5.3 software was used for meta-analysis after two researchers independently screened literature,extracted data,and evaluated the risk of bias in the included studies.RESULTS A total of 23 pieces of literature were included,the quality of which was medium or above,and the total sample size was 43878.The results of meta-analysis showed that the patients were male(OR=1.58,95%CI:1.25-2.01,P=0.002)and≥60 years old(OR=2.60,95%CI:1.76-2.87,P<0.001),physical index≥25.3 kg/m2(OR=1.6,95%CI:1.00-1.12,P=0.040),smoking history(OR=1.89,95%CI:1.31-2.73,P<0.001),chronic obstructive pulmonary disease(OR=1.49,95%CI:1.22-1.83,P<0.001),enterostomy(OR=1.47,95%CI:1.26-1.70,P<0.001),history of abdominal surgery(OR=2.90,95%CI:1.67-5.03,P<0.001),surgical site(OR=1.2,95%CI:1.40-2.62,P<0.001),operation method(OR=1.68,95%CI:1.08-2.62,P=0.020),operation duration(OR=2.65,95%CI:1.92-3.67,P<0.001),abdominal adhesion grade(OR=2.52,95%CI:1.90-3.56,P<0.001),postoperative opioid history(OR=5.35,95%CI:3.29-8.71,P<0.001),tumor TNM staging(OR=2.58,95%CI:1.84-3.62,P<0.001),postoperative blood transfusion(OR=2.92,95%CI:0.88-9.73,P=0.010)is a risk factor for postoperative gastrointestinal dysfunction in patients with gastrointestinal tumors.CONCLUSION There are many factors affecting gastrointestinal dysfunction in gastrointestinal patients after surgery.Clinical staff should identify relevant risk factors early and implement targeted intervention measures on the basis of personalized assessment to improve the clinical prognosis of patients.
文摘BACKGROUND Acute cholecystitis(AC)is a common disease in general surgery.Laparoscopic cholecystectomy(LC)is widely recognized as the"gold standard"surgical procedure for treating AC.For low-risk patients without complications,LC is the recommended treatment plan,but there is still controversy regarding the treatment strategy for moderate AC patients,which relies more on the surgeon's experience and the medical platform of the visiting unit.Percutaneous transhepatic gallbladder puncture drainage(PTGBD)can effectively alleviate gallbladder inflammation,reduce gallbladder wall edema and adhesion around the gallbladder,and create a"time window"for elective surgery.AIM To compare the clinical efficacy and safety of LC or PTGBD combined with LC for treating AC patients,providing a theoretical basis for choosing reasonable surgical methods for AC patients.METHODS In this study,we conducted a clinical investigation regarding the combined use of PTGBD tubes for the treatment of gastric cancer patients with AC.We performed searches in the following databases:PubMed,Web of Science,EMBASE,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Database.The search encompassed literature published from the inception of these databases to the present.Subsequently,relevant data were extracted,and a meta-analysis was conducted using RevMan 5.3 software.RESULTS A comprehensive analysis was conducted,encompassing 24 studies involving a total of 2564 patients.These patients were categorized into two groups:1371 in the LC group and 1193 in the PTGBD+LC group.The outcomes of the meta-analysis revealed noteworthy disparities between the PTGBD+LC group and the LC group in multiple dimensions:(1)Operative time:Mean difference(MD)=17.51,95%CI:9.53-25.49,P<0.01;(2)Conversion to open surgery rate:Odds ratio(OR)=2.95,95%CI:1.90-4.58,P<0.01;(3)Intraoperative bleeding loss:MD=32.27,95%CI:23.03-41.50,P<0.01;(4)Postoperative hospital stay:MD=1.44,95%CI:0.14-2.73,P=0.03;(5)Overall postoperative compli-cation rate:OR=1.88,95%CI:1.45-2.43,P<0.01;(6)Bile duct injury:OR=2.17,95%CI:1.30-3.64,P=0.003;(7)Intra-abdominal hemorrhage:OR=2.45,95%CI:1.06-5.64,P=0.004;and(8)Wound infection:OR=0.These find-ings consistently favored the PTGBD+LC group over the LC group.There were no significant differences in the total duration of hospitalization[MD=-1.85,95%CI:-4.86-1.16,P=0.23]or bile leakage[OR=1.33,95%CI:0.81-2.18,P=0.26]between the two groups.CONCLUSION The combination of PTGBD tubes with LC for AC treatment demonstrated superior clinical efficacy and enhanced safety,suggesting its broader application value in clinical practice.