快速康复外科在食管癌手术患者中应用效果的系统评价与Meta分析  

Application effect of fast track surgery for patients with esophageal cancer:A systematic review and meta-analysis

作　　者：刘晶晶 鲁嘉驹 师将 林庆玲[2] 郭鸿[2] 田金徽[3] 刘健[2] 杨克虎[3] LIU Jingjing;LU Jiaju;SHI Jiang;LIN Qingling;GUO Hong;TIAN Jinhui;LIU Jian;YANG Kehu(The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, P.R.China;Department of lCU, The First Hospital of Lanzhou University, Lanzhou, 730000, P.R.China;Evidence-based Medicine Center, Lanzhou University, Lanzhou, 730000, P.R.China)

机构地区：[1]兰州大学第一临床医学院,兰州730000 [2]兰州大学第一医院重症医学科,兰州730000 [3]兰州大学循证医学中心,兰州730000

出　　处：《中国胸心血管外科临床杂志》2018年第7期596-603,共8页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的采用系统评价的方法探讨快速康复外科(fast track surgery,FTS)在食管癌手术患者中的应用效果。方法计算机检索Pub Med、EMbase、The Cochrane Library、Web of Science、CBM、CNKI和万方数据库中关于食管癌围手术期应用FTS治疗的随机对照试验(randomized controlled trial,RCT)以及观察性研究(observational study),检索时间为建库至2017年5月。由2名研究员按纳入与排除标准分别筛选文献和提取资料并进行偏倚评价。采用Stata12.0软件进行Meta分析。采用Cochrane协作网对RCT进行质量评价。结果最终纳入13项RCT和5项观察性研究,共2 447例患者。Meta分析结果显示:与non-FTS组比较,FTS组术后并发症发生率降低[OR=0.53,95%CI(0.40,0.71),P<0.05],但两组的重新入院率[OR=1.21,95%CI(0.83,1.76),P=0.313]和死亡率[OR=0.72,95%CI(0.43,1.20),P=0.207]差异无统计学意义。结论与non-FTS相比,FTS能更安全有效地促进食管癌患者术后恢复,具有临床应用价值。Objective To evaluate the effect of fast track surgery （FTS） after esophageal cancer surgery. Methods The randomized controlled trial （RCT） and observational studies about FTS for esophageal cancer in PubMed, EMbase, The Cochrane Library, Web of Science, CBM~ CNKI and WanFang databases were searched up to May 2017. Then the studies were screened according to the inclusion and exclusion criteria by two researchers. Data were analyzed by Statal2.0 software. Results Totally 13 RCTs and 5 observational studies with 2 447 patients were eligible for analysis. Compared with the control group, incidence of postoperative complications （OR=0.53, 95%CI 0.40 to 0.71, P〈0.05） significantly reduced in the FTS group, but there was no significant difference between the two groups in readmission rate （OR 1.21, 95%CI 0.83 to 1.76, P=0.313） and 30 d mortality rate （OR=0.72, 95%CI 0.43 to 1.20, P=0.207）. Conclusion FTS can safely and effectively accelerate the recovery of patients with esophageal cancer and it owns important clinical values.

关 键 词：食管癌 快速康复外科 同手术期 系统评价 

分 类 号：R735.1[医药卫生—肿瘤]