手术后更好的康复手术方案和紧急手术:随机对照试验的系统审查和元分析
Benjamin M Mac Curtain1, Aaron O'Mahony1, Hugo C Temperley1
1Department of Surgery, St. John of God Subiaco Hospital, Subiaco, Western Australia, Australia.
ANZ journal of surgery
|June 7, 2023
概括
在紧急情况下,手术后增强恢复 (ERAS) 协议可以改善患者的康复. 这次系统性审查发现,ERAS协议可以加速恢复饮食和浮,减少疼痛,缩短住院时间,而不会增加不良事件.
科学领域:
- 外科手术 手术手术
- 关键护理医学 关键护理医学
- 基于证据的医学基于证据的医学.
背景情况:
- 在选择性手术中建立了手术后增强恢复 (ERAS) 协议.
- 它们在紧急手术环境中的应用需要特定的适应.
- 在紧急情况下,经过修改的ERAS协议下患者的治疗结果还没有得到很好的定义.
研究的目的:
- 系统地审查和分析紧急外科手术中修改后的ERAS协议.
- 评估这些协议对关键患者康复结果的影响.
- 评估ERAS在紧急手术患者中的安全性.
主要方法:
- 随机试验的系统审查和元分析.
- 在主要数据库 (PubMed,MEDLINE,EMBASE,Cochrane) 中进行全面的文献搜索.
- 科克拉恩偏差风险工具和漏斗图片用于质量评估.
主要成果:
- 包括7项试验,包括573名患者.
- 埃拉斯协议显著减少了鼻胃管抽取,第一次液体/固体饮食,腹,便通道,排水和尿道导管切除的时间.
- 根据ERAS协议,平均疼痛评分和住院时间显著减少.
结论:
- 修改后的ERAS协议可以在紧急手术中改善患者的恢复.
- 这些协议导致肠道功能更快恢复,减少住院时间.
- 在紧急情况下实施ERAS时,没有观察到不良结果的统计显著增加.
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