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在循环静脉切除术关闭之前的高效四肢刺激:系统性审查和元分析

A J Lloyd^1,2, N P Hardy³, P Jordan³

¹Department of Surgery, Tallaght University Hospital, Dublin, Ireland. anguslloyd@rcsi.ie.

Techniques in coloproctology

|December 14, 2023

概括

在闭口前进行手术前生理刺激 (PPS) 可以缩短住院时间并减少并发症. 然而,这次元分析没有发现手术后子 (POI) 发生率有显著的减少. 需要进一步的研究来证实这些发现.

科学领域:

胃肠病学和手术结果.
临床试验的元分析和系统审查.

背景情况:

手术后结节 (POI) 是循环结节切除术闭合后的一个常见并发症.
调查手术前生理刺激 (PPS) 的有机四肢,以减轻POI的发生率.

研究的目的:

为了确定手术前生理刺激 (PPS) 是否降低了循环静脉关闭后手术后静脉 (POI) 的发生率.

主要方法:

一个符合PRISMA的随机研究元分析,比较PPS与无刺激.
在PubMed,EMBASE和CENTRAL数据库中搜索到2023年1月30日.
分析了主要终点 (POI发病率) 和二次终点,包括时间到/便,口服饮食恢复,鼻胃管 (NGT) 放置,停留时间 (LOS) 和并发症.

主要成果:

包括3项涉及235名患者的研究.
PPS与更快的口服饮食恢复 (p=0.02) 和更短的LOS (p=0.004) 相关.
与PPS (OR 0.42,p=0.05) 观察到的其他并发症较少,但POI发生率 (OR 0.35,p=0.10) 和NGT放置 (OR 0.50,p=0.12) 并没有显著差异.

结论:

PPS可能会减少LOS和术后并发症,但没有明显影响POI发生率.
试验的顺序分析表明大多数结果的估计不准确.
需要进一步的高功率研究来证实或反驳PPS所观察到的好处.

关键词:

关闭关闭关闭有效的有效的.皮质静脉切开术 (ileostomy) 是一种切开术.伊利乌斯 (Ileus) 是一个小岛.刺激刺激是一种刺激.

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