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在紧急腹腔外科手术后改善手术后的恢复方案:系统性审查和元分析

Tyler McKechnie^1,2, Léa Tessier³, Victoria Archer^1,2

¹Division of General Surgery Department of Surgery, McMaster University, St. Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.

European journal of trauma and emergency surgery : official publication of the European Trauma Society

|November 20, 2023

概括

手术后增强恢复 (ERAS) 协议可以减少紧急腹腔外科手术的停留时间和发病率. 然而,证据质量较低,对长期的术后大脑膜或再入院率没有重大影响.

科学领域:

手术结果研究研究.
基于证据的医学基于证据的医学.
进行元分析和系统审查.

背景情况:

手术后增强恢复 (ERAS) 协议是多模式的周围手术途径,旨在优化手术患者的恢复.
与传统护理相比,它们在紧急腹内外科手术中的应用仍在研究中.

研究的目的:

系统地审查和元分析ERAS协议与接受紧急腹腔外科手术的患者的传统护理的有效性.
评估对手术后停留时间,发病率,长期的手术后骨髓和再录取的影响.

主要方法:

在 MEDLINE,EMBASE,WoS,CENTRAL 和 Pubmed 的综合文献搜索到 2022 年 12 月.
包括随机对照试验和非随机研究,将ERAS协议与传统护理进行比较.
使用逆方差随机效应模型进行元分析;使用Cochrane工具和GRADE评估的偏差风险和证据确定性.

主要成果:

对20项研究的分析 (3548名患者) 显示,在上部和下部胃肠道手术中,术后停留时间缩短.
在上下肠道外科手术中,ERAS协议与术后发病率的降低有关.
没有观察到延长的术后内脏病的显著减少,也没有观察到非显著的再入院风险增加.

结论:

目前支持ERAS协议用于紧急腹腔外科手术的证据确定性低至非常低.
现有的数据因不准确而受到限制,需要进一步进行高质量的研究.

关键词:

结肠直肠外科手术是什么意思紧急外科手术紧急外科手术手术后更好的康复术后更好的康复增强的恢复程序恢复程序.一般外科手术是一般的.

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