预康复干预及其组件的相对有效性:系统性审查与随机对照试验的网络和组件网络元分析
Daniel I McIsaac1, Gurlavine Kidd2, Chelsia Gillis3
1Department of Anesthesiology and Pain Medicine, University of Ottawa, Clinical Epidemiology Program, Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada dmcisaac@toh.ca.
概括
预康复,包括运动和营养,可以减少手术并发症和住院时间. 多组件干预措施对改善手术患者的生活质量和身体恢复有希望.
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.
- 医疗服务研究 医疗服务研究
背景情况:
- 预康复干预旨在改善患者在手术前的结果.
- 组件包括运动,营养,认知和心理社会支持.
- 优化患者对手术的准备对于康复至关重要.
研究的目的:
- 评估手术患者预康复组件的比较有效性.
- 评估对术后并发症,入院时间,生活质量和身体恢复的影响.
- 通过网络元分析,综合随机对照试验的证据.
主要方法:
- 186个随机对照试验 (15,684名参与者) 的系统审查和网络元分析.
- 在多个数据库 (Medline,Embase等) 进行的搜索. 更新到2023年10月.
- 使用网络元分析信心 (CINeMA) 方法评估的证据确定性.
主要成果:
- 孤立的运动和营养,以及联合的运动,营养和心理社会预康复减少了并发症.
- 各种预康复策略,特别是运动与心理社会相结合的策略,减少了逗留时间.
- 运动,营养和心理社会预康复的结合改善了生活质量和身体恢复.
- 运动和营养是改善结果的关键组成部分,对这些干预措施有强有力的发现.
结论:
- 运动和营养预康复,以及含有运动的多组分干预措施,对手术患者显示出潜在的益处.
- 在临床实践中,对于接受手术的成年人来说,这些干预措施可能会被考虑.
- 需要进一步进行高质量的多中心试验,以增加预康复疗效的确定性.
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