AIM:To compare the safety of fast-track rehabilitation protocols(FT) and conventional care strategies(CC),or FT and laparoscopic surgery(LFT) and FT and open surgery(OFT) after gastrointestinal surgery.METHODS:We sear...AIM:To compare the safety of fast-track rehabilitation protocols(FT) and conventional care strategies(CC),or FT and laparoscopic surgery(LFT) and FT and open surgery(OFT) after gastrointestinal surgery.METHODS:We searched MEDLINE,WHO International Trial Register,Embase and The Cochrane Central Register of Controlled Trials up to 2014 for randomized controlled trials(RCTs) comparing FT and CC or comparing LFT and OFT,with 10 or more randomized participants and about 30 d follow-up.Two reviewers independently extracted data on complications,anastomotic leak,obstruction,wound infection,re-admission between FT and CC or LFT and OFT after gastrointestinal surgery.RESULTS:Twenty-four RCTs of FT vs CC or LFT vs OFT were included.Compared with CC,FT reduced overall complications and wound infection.However,anastomotic leak,obstruction and re-admission were not significantly reduced.The pooled risk ratio(RR) of 0.69(95%CI:0.60-0.78; P < 0.001),pooled RR of 0.71(95%CI:0.57-0.88; P < 0.001),pooled RR of 0.93(95%CI:0.68-1.25; P > 0.05),a pooled RR of 0.87(95%CI:0.67-1.15; P > 0.05) and pooled RR of 0.94(95%CI:0.73-1.22; P > 0.05) respectively.Compared with OFT,LFT reduced complications,with a pooled RR of 0.66(95%CI:0.54-0.81; P < 0.001).CONCLUSION:FTs are safe after gastrointestinal surgery.Additional large,prospective RCTs should be conducted to establish further the safety of this approach.展开更多
目的探究多学科团队(Multidisciplinary Team,MDT)协作下的护理干预对主动脉夹层介入术后患者的康复效果。方法随机选取2020年1月—2022年1月期间于莆田市第五医院住院的80例行主动脉夹层介入术的患者为研究对象。将2020年1月—2021年1...目的探究多学科团队(Multidisciplinary Team,MDT)协作下的护理干预对主动脉夹层介入术后患者的康复效果。方法随机选取2020年1月—2022年1月期间于莆田市第五医院住院的80例行主动脉夹层介入术的患者为研究对象。将2020年1月—2021年1月入院的38例患者列为常规组,术后予以常规护理;2021年2月—2022年1月入院的42例患者列为MDT组,术后予以MDT护理。比较两组患者术后的康复进程、世界卫生组织生存质量量表简表(Quality of Life Scale-BREF,QOL-BREF)评分和并发症发生差异。结果MDT组患者术后下床时间、住院时间均短于常规组,差异有统计学意义(P均<0.05)。干预后MDT组和常规组的QOL-BREF评分均高于干预前,且MDT组高于常规组,差异有统计学意义(P均<0.05)。术后MDT组患者的并发症发生率为4.76%,低于常规组的21.05%,差异有统计学意义(χ^(2)=4.841,P<0.05)。结论MDT协作下的护理干预在主动脉夹层介入术后患者中应用,有利于患者康复进程,提高生存质量,降低并发症风险。展开更多
基金Supported by The National Natural Science Foundation of China,No.81172279
文摘AIM:To compare the safety of fast-track rehabilitation protocols(FT) and conventional care strategies(CC),or FT and laparoscopic surgery(LFT) and FT and open surgery(OFT) after gastrointestinal surgery.METHODS:We searched MEDLINE,WHO International Trial Register,Embase and The Cochrane Central Register of Controlled Trials up to 2014 for randomized controlled trials(RCTs) comparing FT and CC or comparing LFT and OFT,with 10 or more randomized participants and about 30 d follow-up.Two reviewers independently extracted data on complications,anastomotic leak,obstruction,wound infection,re-admission between FT and CC or LFT and OFT after gastrointestinal surgery.RESULTS:Twenty-four RCTs of FT vs CC or LFT vs OFT were included.Compared with CC,FT reduced overall complications and wound infection.However,anastomotic leak,obstruction and re-admission were not significantly reduced.The pooled risk ratio(RR) of 0.69(95%CI:0.60-0.78; P < 0.001),pooled RR of 0.71(95%CI:0.57-0.88; P < 0.001),pooled RR of 0.93(95%CI:0.68-1.25; P > 0.05),a pooled RR of 0.87(95%CI:0.67-1.15; P > 0.05) and pooled RR of 0.94(95%CI:0.73-1.22; P > 0.05) respectively.Compared with OFT,LFT reduced complications,with a pooled RR of 0.66(95%CI:0.54-0.81; P < 0.001).CONCLUSION:FTs are safe after gastrointestinal surgery.Additional large,prospective RCTs should be conducted to establish further the safety of this approach.
文摘目的探究多学科团队(Multidisciplinary Team,MDT)协作下的护理干预对主动脉夹层介入术后患者的康复效果。方法随机选取2020年1月—2022年1月期间于莆田市第五医院住院的80例行主动脉夹层介入术的患者为研究对象。将2020年1月—2021年1月入院的38例患者列为常规组,术后予以常规护理;2021年2月—2022年1月入院的42例患者列为MDT组,术后予以MDT护理。比较两组患者术后的康复进程、世界卫生组织生存质量量表简表(Quality of Life Scale-BREF,QOL-BREF)评分和并发症发生差异。结果MDT组患者术后下床时间、住院时间均短于常规组,差异有统计学意义(P均<0.05)。干预后MDT组和常规组的QOL-BREF评分均高于干预前,且MDT组高于常规组,差异有统计学意义(P均<0.05)。术后MDT组患者的并发症发生率为4.76%,低于常规组的21.05%,差异有统计学意义(χ^(2)=4.841,P<0.05)。结论MDT协作下的护理干预在主动脉夹层介入术后患者中应用,有利于患者康复进程,提高生存质量,降低并发症风险。
