在腹部上部手术中的多模式预康复和术后结果:系统性审查和元分析
Farshad Amirkhosravi1, Kelvin C Allenson1, Linda W Moore1
1Department of Surgery, Houston Methodist, Houston, TX, USA.
Scientific reports
|July 11, 2024
概括
多模式预康复可显著减少术后并发症,包括肺部问题,在腹部上部手术患者. 虽然它并不总是缩短住院时间,但添加运动可以改善结果.
科学领域:
- 手术成果研究的研究结果.
- 基于证据的医学是基于证据的医学.
- 优化患者康复,优化患者康复.
背景情况:
- 在腹部上部手术中术后并发症仍然是一个重大问题.
- 多式联络预康复在减轻这些风险方面的作用尚未完全被理解.
- 现有的研究缺乏对随机试验的全面分析.
研究的目的:
- 系统地审查和分析评估多模式预康复的随机对照试验 (RCT).
- 评估预康复对患者和医院结局的影响,特别是术后并发症和住院时间.
- 综合有关预康复干预措施在选择性腹部上部手术前有效性的证据.
主要方法:
- 对相关RCT进行了MEDLINE,Embase,CINAHL和Cochrane CENTRAL的全面文献搜索.
- 由两个审稿人进行独立选,数据提取和质量评估.
- 使用随机效应模型的元分析来评估二分法 (log-odds比率) 和连续 (平均差异) 结果.
主要成果:
- 十项涉及1503名患者的研究被纳入了分析.
- 多模式预康复显著降低了整体术后并发症的几率 (OR = -0.38,P = 0.048).
- 预康复实质性地降低了术后肺部并发症 (PPC) 的几率 (OR = -0.96,P < 0.001).
- 住院时间没有显著减少,除非运动是预康复的组成部分 (MD = -0.91,P = 0.02).
结论:
- 多模式预康复似乎有效地减少了经过腹部上部手术的患者的术后并发症.
- 将运动纳入预康复方案对于减少住院时间至关重要.
- 需要进一步的研究来解决当前文献中的异质性,并完善预康复策略.
相关概念视频
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
71
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
71
01:29Appendicitis-II: Diagnostic Studies and Management
74
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
74
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
282
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
282