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非心脏手术患者的限制性与传统病房液体治疗以及对术后并发症的影响:元分析

Joachim J Bosboom^1,2,3, Marije Wijnberge^1,2, Bart F Geerts⁴

¹Department of Anesthesiology, Amsterdam UMC, Amsterdam University, Amsterdam, the Netherlands.

Perioperative medicine (London, England)

|September 22, 2023

概括

限制性流体饮食可以减少非心脏手术后的术后并发症. 虽然有希望,但由于证据质量不佳和本次元分析的样本规模小,需要进一步进行高质量的研究.

科学领域:

麻醉学和外科手术期间的医学.
手术结果研究研究.
关键的护理和流体管理.

背景情况:

有效的流体管理对于手术后增强恢复协议至关重要.
限制静脉注射液体对病房环境中的患者结果的影响尚未得到充分证实.
这项研究解决了围绕非心脏手术后限制性与常规流体治疗方案的不确定性.

研究的目的:

为了研究限制性流体饮食与常规饮食对术后并发症的影响.
分析在临床病房进行非心脏手术的患者的结果.

主要方法:

通过使用到2022年6月的MEDLINE,Embase,Cochrane图书馆和CINAHL数据库的数据进行了系统的元分析.
包括的研究包括三项随机对照试验 (RCT) 和四项非随机研究,共883名成年患者.
数据使用元分析技术进行聚合,计算加权聚合风险比率 (RR) 和几率比率 (OR) 以95%的置信区间 (CI).

主要成果:

限制性流体治疗方案显示,RCT中的整体并发症率显著降低 (RR 0.46,95% CI 0.23-0.95).
在非随机研究中,这种降低并未始终被观察到 (RR 0.74,95% CI 0.53-1.03).
在死亡率方面没有发现显著的关联;然而,在非随机研究中,限制性流体治疗与术后停留时间的缩短有关 (MD -1.81天,95% CI -3.27至-0.35).

结论:

这一元分析表明,病房内的限制性流体治疗可能会积极影响术后并发症的发生率.
证据质量中等到低,样本大小小,RCT和非随机研究混合.
需要进一步进行高质量的研究来证实这些发现,并建立最佳的流体管理策略.

关键词:

流体疗法是一种流体疗法.输液是为了输液.静脉内输入静脉内输入手术后的时间.

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