摘要
目的系统评价快速康复外科（fast track surgery，FTS）在胃癌切除术中应用的安全性和有效性。方法计算机检索1994年1月至2014年3月Pubmed、Medline、Cochranelibrary、Webofscience数据库关于Frs在胃癌切除术中应用的随机对照实验（RCT）或临床对照实验（CCT），并辅用Google进行手工检索。对符合标准的文献采用RevMan5．0软件进行Meta分析。结果5组RCT和2组CCT纳入研究，共有636例患者，其中FTS组309例，对照组327例。Meta分析结果显示：FTS组较对照组术后肠道通气时间提前[WMD=-18．74，95％CI（-34．31，-3．17），P〈0．05]、住院时间减少[WMD=-2．46，95％CI（-3．75，-1．17），P=0．0002]、住院费用减少[SMD=-0．67，95％CI（-1．00，-0．34），P〈0．0001]，但在手术时间、术中出血量、术中淋巴结清扫数目、导尿管拔除时间及并发症发生率方面相比差异均无统计学意义（均P〉0．05）。结论FFS在胃癌切除术中应用能够促进术后肠道功能恢复、缩短住院时间和减少住院费用，从而加速患者康复出院。
Objective To review the safety and efficacy of fast track surgery in gastrectomy for gastric cancer. Methods The computer retrieved databases, including Pubmed, Medline, Cochrane library and Web of science, to collect randomized controlled trials （ RCT ） or controlled clinical trials （CCTS） on Fins was used in gastrectomy for gastric cancer between January 1994 and march 2014, and manual retrieval in Google. Using RevManS. 0 software analysis data that extract from collect literature. Results A total of five RCTs and two CCTs, involving 636 patients,were included, there were 309 cases in experimental group （FTS group） and 327 cases in control group. Metanalysis showed： the FFS group had earlier postoperative flatus [WMD = - 18.74, 95% CI （ - 34. 31, - 3.17）, P 〈0.05], shorter postoperative hospital stay [ WMD = - 2.46, 95% CI （ - 3.75, - 1.17 ）, P = 0. 000 2 ], and lower hospital charge [SMD= -0.67, 95% CI （ -1.00, -0.34）, P〈0.000 1]. However, there were no statistically significant differences in operation time, intraoperative blood loss, the number of retrieved lymph node intraoperative, the time of catheter removal and postoperative complication rate （P 〉 0. 05 ） . Conclusion FTS in gastrectomy for gastric cancer can promote postoperative bowel function recovery, decrease postoperative hospital stay and reduce hospital charge.
出处
《中华普通外科杂志》
CSCD
北大核心
2015年第10期808-812,共5页
Chinese Journal of General Surgery
基金
国家自然科学基金资助项目（81372364）
江苏省消化疾病临床医学研究中心资助项目（BL2012001）
