加速康复外科技术在老年肺癌手术病人中应用效果的Meta分析  

Application effect of enhanced recovery after surgery technology in elderly patients with lung cancer surgery:a Meta-analysis

作　　者：吴雪 杨川川 李燕 魏肖倩 王秋静 李静 王伟[1] WU Xue;YANG Chuanchuan;LI Yan;WEI Xiaoqian;WANG Qiujing;LI Jing;WANG Wei(Tianjin University of Traditional Chinese Medicine,Tianjin 301617 China)

机构地区：[1]天津中医药大学,天津301617 [2]天津医科大学肿瘤医院国家肿瘤临床医学研究中心

出　　处：《护理研究》2020年第24期4324-4330,共7页Chinese Nursing Research

基　　金：天津医科大学肿瘤医院科研项目,编号:H1901。

摘　　要：[目的]通过Meta分析明确加速康复外科(ERAS)技术对老年肺癌手术病人临床效果的影响。[方法]计算机检索PubMed、EMbase、Web of Science及中国知网、万方、维普等数据库,收集有关老年肺癌手术病人应用ERAS的随机对照试验文献。检索时限为建库至2020年4月30日,按照纳入、排除标准进行文献筛选、资料提取和文献质量评价后,采用RevMan 5.3软件进行Meta分析。[结果]共纳入10项研究,样本量共计1109例。Meta分析结果显示,ERAS能降低手术后并发症发生率[OR=0.49,95%CI(0.35,0.68),P<0.0001]及肺部感染发生率[OR=0.40,95%CI(0.25,0.65),P<0.001],缩短胸腔引流管留置时间[MD=-1.68,95%CI(-2.27,-1.09),P<0.0001],促进病人术后早期下床[MD=-22.13,95%CI(-26.71,-17.55),P<0.0001],缩短病人的住院时间[MD=-2.87,95%CI(-3.46,-2.27),P<0.0001]。[结论]现有证据表明,ERAS有助于改善老年肺癌病人术后恢复情况,但证据尚不充足,且各研究差异较大,后期需要开展更多高质量的研究进行佐证。Objective:To analyze and determine the impact of enhanced recovery after surgery(ERAS)on the clinical effect of elderly patients who underwent lung cancer surgery through Meta-analysis.Methods:The randomized controlled trials(RCTs)of using ERAS in elderly patients who underwent lung cancer surgery were retrieved from PubMed,EMbase,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database,and other databases.The retrieval time limit was from the establishment of the database to April 30,2020.After the literature screening,data extraction,and literature quality evaluation according to the inclusion and exclusion criteria,the RevMan 5.3 software was used for Meta-analysis.Results:A total of 10 studies were included,involving 1109 cases.Meta-analysis showed that ERAS could reduce the incidence of postoperative complications[OR=0.49,95%CI(0.35,0.68),P<0.0001],the incidence of pulmonary infection[OR=0.40,95%CI(0.25,0.65),P<0.001],shorten the indwelling time of thoracic drainage tube[MD=-1.68,95%CI(-2.27,-1.09),P<0.0001],shorten the length of stay[MD=-2.87,95%CI(-3.46,-2.27),P<0.0001],and promote the early ambulation of patients[MD=-22.13,95%CI(-26.71,-17.55),P<0.0001].Conclusions:Existing evidence showed that ERAS was helpful to improve the postoperative recovery of elderly patients with lung cancer,while the evidences were not sufficient and the differences among studies were significant.More high-quality studies were needed in the later period of research.

关 键 词：加速康复外科 肺癌 老年人 META分析 并发症 肺部感染 胸腔引流管 住院时间 

分 类 号：R47[医药卫生—护理学]