快速康复外科理念在肝切除术围手术期应用的安全性与可行性Meta分析  

SAFETY AND FEASIBILITY OF FAST TRACK SURGERY IN PERIOPERATIVE PERIOD OF HEPATECTOMY:A META-ANALYSIS

作　　者：黄坤[1] 马佳怡[1] 林友刚[1] 

机构地区：[1]海南省人民医院胃肠外一科,海南海口570000

出　　处：《河北医科大学学报》2014年第11期1263-1267,共5页Journal of Hebei Medical University

摘　　要：目的利用Meta分析评价快速康复外科理念在肝切除术围手术期的安全性及可行性。方法检索PubMed、Embase、ScinceDirect、Google Scholar、万方医学网及中国知网2014年3月之前在肝切除术围手术期应用快速康复理念及传统方法的研究,根据文献评价标准对研究进行评价,对纳入的研究进行安全性及可行性相关指标的Meta分析。结果 7个随机对照研究及2个非随机对照研究共纳入1 072例患者,快速康复理念组511例,传统方案组561例。快速康复理念可减少总的术后并发症发生率(相对危险度=-0.01,95%CI=-0.06^-0.03,P=0.58)、加快胃肠道恢复(加权均数差=-0.90,95%CI=-1.28^-0.52,P<0.01)、减少术后住院时间(加权均数差=-2.45,95%CI=-3.99^-0.91,P<0.01),而与传统方法在胆漏、腹腔脓肿、胸腔大量积液等严重并发症方面差异无统计学意义(相对危险度=0.93,95%CI=0.60~1.45,P=0.75)。结论快速康复理念在肝切除术围手术期是安全可行的。Objective To systematically evaluate the safety and feasibility of fast track surgery in perioperative period of hepatectomy.Methods Literatures of PubMed,Embase, ScinceDirect,Google Scholar,WanFang and CNKI published before March 2014 were searched. The methodological quality including RCTs and CCTs were assessed.Results Seven RCTs and two CCTs involving 1 072 patients met the inclusion criteria.Compared with those by conventional way the patients managed by fast track surgery had less complications （RR=-0.01,95%CI=-0.06 to -0.03,P=0.58）,faster bowel function recovery （MD=-0.90,95%CI=-1.28 to -0.52,P〈0.01）and shorter postoperative hospital stay （MD=-2.45,95%CI=-3.99 to -0.91,P〈0.01）,but not statistically increased severe complications （bile leak,pleural effusion,intraperitoneal abscess）（RR=0.93,95%CI=0.60 to 1.45,P=0.75）.Conclusion Fast track surgery is safe and feasible in perioperative period of hepatectomy.

关 键 词：肝切除术 康复 META分析 

分 类 号：R657.3[医药卫生—外科学]