快速康复外科在腹腔镜胆囊切除术围手术期应用的Meta分析  

Application of fast track surgery in perioperative period of laparoscopic cholecystectomy: a Meta-analysis

作　　者：梁豪[1] 熊志勇[2] 姚志成[2] 胡昆鹏[2] 李瑞曦[1] 周伯宣 许瑞云[1] 邓美海[1] Liang Hao Xiong Zhiyong Yao Zhicheng Hu Kunpeng Li Ruixi Zhou Boxuan Xu Ruiyun Deng Meihai(Department of Hepatobiliary Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Cruangzhou 510630, China Department of General Surgery, Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510530, China)

机构地区：[1]中山大学附属第三医院肝胆外科,广州510630 [2]中山大学附属第三医院岭南医院普通外科,广州510530

出　　处：《中华肝脏外科手术学电子杂志》2017年第4期307-311,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：广东省科技计划项目(2014A020212122);广东省自然科学基金(2016A030313848)

摘　　要：目的探讨快速康复外科(FTS)在腹腔镜胆囊切除术(LC)围手术期中的临床应用价值。方法计算机检索Pubmed、OVID、Elsevier Sciencedirect、Cochrane Library、Embase、中国知网(CNKI)、中国生物医学文献服务系统(CBM)和万方学术期刊全文数据库等,收集2016年12月之前公开发表的有关FTS在LC中应用的随机对照试验(RCT)文献。根据Cochrane Handbook推荐的文献质量评价办法对符合纳入标准的文献进行质量评价。提取手术情况、术后情况、住院时间及费用等数据。异质性研究采用随机效应模型,同质性研究采用固定效应模型。结果共纳入19篇RCT文献,总计4 454例患者,其中FTS组2 228例,对照组2 226例。Meta分析结果显示,与对照组相比,FTS组能明显缩短手术时间、术后首次下床活动时间、术后首次肛门排气时间以及住院时间,并减少住院费用(MD=-0.94,-9.59,-19.46,-2.11,-1 462.92;P<0.05)。结论 FTS应用于LC围手术期能明显缩短手术时间,加速患者康复及减少住院费用。Objective To investigate the clinical application value of fast track surgery （FTS） in the perioperative period of laparoscopic cholecystectomy （LC）. Methods Randomized control trials （RCT） literatures related to the application of FTS in LC up to December 2016 were searched by computer from PubMed, OVID, Elsevier Sciencedirect, Cochrane Library, Embase, CNKI, China Biology Medicine Disc （CBM） and Wanfang database. The quality of the included literatures was evaluated according to the literature quality assessment method recommended by Cochrane Handbook. Relevant data including surgical status, postoperative status, length of hospital stay and hospitalization expense were extracted. Heterogenous studies were analyzed using random effect model, and homogenous studies were analyzed using fixed effect model. Results A total of 4 454 patients in 19 RCT literatures were included in this study. Among them, 2 228 cases were assigned in the FTS group and 2 226 in the control group. Meta-analysis indicated that, the operation time, first postoperative off-bed time, first postoperative anal exhaust time and length of hospital stay in the FTS group were significantly shorter than those in the control group, and the hospitalization expense was significantly less than that in the control group （MD=-0.94, -9.59, -19.46, -2.11, -1 462.92; P〈0.05）. Conclusions Application of FTS in the perioperative period of LC can significantly shorten the operation time, accelerate the postoperative recovery of the patients and reduce the hospitalization expense.

关 键 词：快速康复外科 胆囊切除术 腹腔镜 围手术期医护 META分析 随机对照试验 

分 类 号：R657.4[医药卫生—外科学]