食管癌患者多联预康复干预效果随机对照试验的meta分析  

Effectiveness of multimodal prehabilitation in patients with esophageal neoplasm:a meta-analysis of RCTs

作　　者：王建华 张王剑[2] 黄思佳 刘莉[3] WANG Jianhua;ZHANG Wangjian;HUANG Sijia;LIU Li(Health Statistics Association of Guangdong Province,Guangzhou 510060,China;School of Public Health,Sun Yat-sen University,Guangzhou 510080,China;Department of Nursing,Sun Yat-sen University Cancer Center,Guangzhou 510062,China)

机构地区：[1]广东省卫生统计学会,广东广州510060 [2]中山大学公共卫生学院医学统计学系,广东广州510080 [3]中山大学肿瘤防治中心护理部,广东广州510062

出　　处：《新医学》2024年第8期641-649,共9页Journal of New Medicine

基　　金：广东省食管癌研究所科技计划项目(M202319)。

摘　　要：目的 通过meta分析评价多联预康复在食管癌患者术后恢复中的应用效果。方法 检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方、维普、中国生物医学文献数据库中关于多联预康复应用于食管癌患者的随机对照试验,检索范围设定从建库起至2023年10月1日,纳入文献在质量学评价后,用RevMan5.4软件进行meta分析。结果 纳入10篇文献共930例患者,meta分析结果显示,多联预康复相对于常规护理可降低食管癌患者术后并发症发生率[相对危险度(RR)=0.62,95%CI 0.47~0.82],缩短住院时间[均数差(MD)=-6.15 d,95%CI-7.87~-4.43 d]及降低住院费用(MD=-1.78万元,95%CI-2.76万元~-0.81万元),增加术后6分钟步行距离(MD=93.35 m,95%CI 36.19~150.51 m),提高术后血清白蛋白含量(MD=6.18 g/L,95%CI 4.08~8.28 g/L)和免疫球蛋白(Ig)G含量[标准化均数差(SMD)=1.21,95%CI 1.01~1.42]。结论 多联预康复有利于食管癌患者术后恢复,降低术后并发症发生率,改善部分运动、营养和免疫功能指标,缩短住院时间且减少住院费用。Objective To evaluate the effectiveness of multimodal prehabilitation among patients with esophageal neoplasm through meta-analysis.Methods Randomized controlled trials(RCTs)reporting the effectiveness of multimodal prehabilitation in patients with esophageal neoplasm were searched from PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang,Chongqing VIP and CBM databases from the inception to October 1,2023.Meta-analysis was performed by RevMan 5.4 software after quality evaluation.Results Ten RCTs consisting of 930 patients were included in this meta-analysis.The meta-analysis results showed that compared with conventional nursing,multimodal prehabilitation could lower the incidence of postoperative complications(relative risk(RR)=0.62,95%CI 0.47-0.82),and shorten the length of hospital stay(mean difference(MD)=-6.15 d,95%CI-7.87--4.43 d),reduce hospital costs(MD=CNY-17800,95%CI-27600--8100),prolong 6-minute walking distance(MD=93.35 m,95%CI 36.19-150.51 m)and increase serum albumin levels(MD=6.18 g/L,95%CI 4.08-8.28 g/L)and IgG levels(standardized mean difference(SMD)=1.21,95%CI 1.01-1.42),respectively.Conclusions Multimodal prehabilitation can accelerate postoperative recovery,decrease the incidence of postoperative complications,improve partial exercise,nutritional and immunological indexes,shorten the length of hospital stay and reduce hospitalization costs.

关 键 词：食管癌 多联预康复 术后恢复 干预效果 随机对照试验 META分析 

分 类 号：R473.73[医药卫生—护理学]