胸腔镜下肺癌根治术患者加速康复效果的Meta分析

doi:10.16460/j.issn1008-9969.2021.23.041

摘要/Abstract

摘要： 目的采用Meta分析探讨加速康复外科在肺癌患者应用胸腔镜技术中促进康复的效果。方法计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、维普数据库,收集有关胸腔镜肺癌患者围手术期应用快速康复理念的随机对照试验和临床对照试验,检索时间截止至2021年6月21日。经严格质量评价后,采用RevMan 5.3 软件进行分析。结果共纳入14项研究,样本量共计1 587例。Meta分析结果显示,加速康复在胸腔镜肺癌手术中可降低术后肺部感染并发症发生[OR=0.43,95%CI（0.25,0.73）,P=0.002]、减少住院费用[MD=-0.62,95%CI（-0.70,-0.53）,P<0.001]、提前拔除胸腔引流管[MD=-2.76,95%CI（-2.96,-2.56）,P<0.001]。结论应用加速康复理念有助于促进肺癌患者的快速康复,降低肺部感染的发生,降低住院费用,符合国家医保政策,值得进一步临床推广应用。

关键词: 加速康复外科, 肺癌, 胸腔镜, Meta分析

Abstract: Objective To explore the rehabilitation effect of enhanced recovery after surgery (ERAS) in lung cancer patients undergoing thoracoscopic radical surgery. Methods We searched databases including PubMed, Web of Science, Embase, Cochrane Library, CNKI and VIP by computer to collect randomized controlled trials and clinical controlled trials on the application of ERAS in perioperative period of lung cancer patients undergoing thoracoscopic radical surgery. The search time was up to June 21, 2021 and RevMan 5.3 software was used for data analysis of the strictly screened studies. Results A total of 14 studies with a sample size of 1,587 were included. Meta analysis showed that ERAS could reduce the incidence of postoperative pulmonary infection complications [OR=0.43, 95%CI(0.25, 0.73), P=0.002] and hospitalization expenses [MD=-0.62, 95%CI(-0.70,-0.53), P<0.001], and remove the thoracic drainage tube in advance [MD=-2.76, 95%CI(-2.96, -2.56), P<0.001]. Conclusion EARS is helpful to promote the rapid rehabilitation of lung cancer patients, and reduce the incidence of pulmonary infection and hospitalization costs, which is in line with the national medical insurance policy, and worthy of further clinical application.

Key words: enhanced recovery after surgery, lung cancer, thoracoscopy, Meta-analysis

中图分类号:

R473.73

梁冬燕, 公丕欣, 邱玲动, 王慧, 邵梅莹, 孙铮. 胸腔镜下肺癌根治术患者加速康复效果的Meta分析[J]. 护理学报, 2021, 28(23): 41-46.

LIANG Dong-yan, GONG Pi-xin, QIU Ling-dong, WANG Hui, SHAO Mei-ying, SUN Zheng. Rehabilitation Effect of Enhanced Recovery after Surgery on Lung Cancer Patients Undergoing Thoracoscopic Radical Surgery：A Meta Analysis[J]. Journal of Nursing, 2021, 28(23): 41-46.

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