加速康复外科理念在头颈癌围手术期中应用的证据图分析  

Evidence map analysis of the application of enhanced recovery after surgery in the perioperative period of head and neck cancer

作　　者：李雅洁 罗明月 张书萌 段欣宇 丁永霞[1] Li Yajie;Luo Mingyue;Zhang Shumeng;Duan Xinyu;Ding Yongxia(Nursing College,Shanxi Medical University,Taiyuan 030001,China;Academy of Medical Sciences,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学护理学院,太原030001 [2]山西医科大学医学科学院,太原030001

出　　处：《中国实用护理杂志》2025年第6期417-427,共11页Chinese Journal of Practical Nursing

基　　金：山西省基础研究计划资助项目(202303021211121)。

摘　　要：目的运用证据图谱的方法,全面识别、描述并评价加速康复外科(ERAS)理念在头颈癌围手术期中应用的研究证据,以了解研究现状,为临床实践及未来该领域的研究提供参考依据。方法采用证据综合研究方法,计算机检索PubMed、Embase、CINAHL、Web of Science、Cochrane Library、中国知网、万方数据库、维普数据库和中国生物医学文献数据库,并手动检索相关参考文献以及OpenGrey灰色文献数据库,检索时限为建库至2024年8月25日,对纳入的文献进行筛选和归纳总结,并分别采用不同的质量评价工具对纳入的研究进行质量评价,采用文字和图表相结合的方式展示研究现状。结果最终纳入105篇文献,包括101篇原始研究与4篇系统评价/Meta分析,文献发表数量总体上随时间变化呈增长趋势,但呈"锯齿状"波动,中国发表的研究最多,研究人群以喉癌和口腔癌患者为主,绝大部分样本量集中在51~100;方法学质量评价结果显示大部分研究质量偏低;干预措施主要涉及预康复、营养支持、预防恶心呕吐等9个主题。结局指标涉及与患者相关和与医院相关2个方面,对并发症发生率、住院时间结局指标关注度最高,对痰液情况、生存时间等结局指标关注度较低,大部分结局指标效果评价显示为"有益",但部分结局效果评价尚存在争议。结论ERAS理念在头颈癌围手术期中的应用中总体上显现出积极效果,但大部分研究质量偏低,未来需要开展更多高质量的临床研究为ERAS理念在该领域中的应用提供更充分的证据。ObjectiveTo comprehensively identify,describe and evaluate the research evidence on the application of ERAS in perioperative head and neck cancer by using the method of evidence mapping,so as to understand the research status and provide reference for clinical practice and future research in this field.MethodsAdopting an evidence-integrated research approach,PubMed,Embase,CINAHL,Web of Science,Cochrane Library,CNKI,Wanfang,VIP and Chinese Biomedical Literature Database were searched by computer.In addition,relevant references and grey literature databases such as OpenGrey were manually searched until August 25,2024,to screen and summarize the included literature,and different quality evaluation tools were used to evaluate the quality of the included studies.The present research situation was presented with text and graphs.ResultsA total of 105 articles were included,including 101 original studies and 4 systematic reviews/Meta-analyses.The number of published literature showed an increasing trend over time,but it fluctuated in a zigzag pattern.The most published studies were in China,and the study population was mainly patients with laryngeal and oral cancer,with a sample size of 51-100 cases.The results of methodology quality evaluation showed that the quality of most studies was relatively low.The intervention measures mainly involved 9 subjects,such as pre-rehabilitation,nutritional support,prevention of nausea and vomiting,and the outcome indicators involved 2 aspects related to patients and hospital.More attention was paid to outcome indicators such as complication rate and length of stay,while less attention was paid to outcome indicators such as condition of sputum and survival time.Most outcome effects were shown to be"beneficial",but some outcome effects were still controversial.ConclusionsERAS has generally shown positive effects in perioperative application of head and neck cancer,but the quality of most studies is low.More high-quality clinical studies are needed in the future to provide more sufficien

关 键 词：头颈部肿瘤 围手术期 加速康复外科 证据图 

分 类 号：R73[医药卫生—肿瘤]