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结肠直肠手术后的延长性皮质,一个系统的审查
Anzil Shereef1, David Raftery2, Fraser Sneddon3
1Institute of Applied Health Sciences, University of Aberdeen, Foresterhill Campus, Aberdeen AB25 2ZN, UK.
Journal of clinical medicine
|September 28, 2023
概括
长期的手术后膜 (POI) 是一个严重的手术问题,管理选择有限. 这一系统性审查发现了显著的数据差距和不一致性,阻碍了对消化器外科手术患者的可靠治疗比较.
科学领域:
- 胃肠病学和外科研究.
- 证据综合和元分析
- 临床试验方法论 临床试验方法论
背景情况:
- 长期的手术后内脏 (POI) 显著影响一般手术患者,特别是在结直肠手术后.
- 目前对POI病因和病理生理学的理解有限,几乎没有有效的管理或预防策略.
- POI导致不良结果,包括长时间住院,增加成本和患者发病率.
研究的目的:
- 系统地审查和综合治疗结肠直肠外科手术后长期手术后大肠的证据.
- 用元分析和信任评估工具评估各种干预措施的证据质量和确定性.
主要方法:
- 随机对照试验 (RCT) 的系统文献综述,比较POI治疗方法.
- 网络元分析 (NMA) 用于直接和间接干预的比较.
- 使用CINeMA的信心评估和通过GRADE的确定性评估;使用Cochrane RoB2工具评估偏差风险.
主要成果:
- 包括七项研究,其中大多数都表现出显著的研究内偏见.
- 高异质性和不一致性阻止了可靠的对对元分析和干预排名.
- 来自网络元分析的间接比较被认为是不可靠的.
结论:
- 在消化器外科手术后,关于延长的阴茎缺陷存在重大知识差距.
- 目前的证据的特点是异质性和不连贯性,而不是纯粹的不精确性.
- 需要进一步进行高质量的干预试验,以解决POI发生的数据缺口,并为临床实践提供信息.
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