摘要
目的评价快速康复外科(fast track surgery,FTS)在乳腺癌患者围手术期护理中的安全性及有效性。方法两位评价者独立地检索万方、中国知网、维普、中国生物医学文献数据库、Pubmed、Cochrane library、EMBASE数据库中有关乳腺癌患者围手术期应用FTS的随机对照实验,用Jadad法评价文献质量,用Review Manager 5.2软件对纳入数据进行Meta分析。结果纳入9篇RCT文献,共995例患者。Meta分析结果表明,FTS组术后总的并发症发生率显著低于对照组(RR=0.59,95%CI 0.41~0.84,P=0.004),其中,FTS组上肢水肿发生率显著低于对照组(RR=0.37,95%CI 0.24~0.57,P<0.000 01),但是,两组在皮下积液、皮瓣坏死发生率的比较,差异无统计学意义(RR皮下积液=0.73,95%CI 0.40~1.34,P=0.31;RR皮瓣坏死=0.55,95%CI 0.26~1.14,P=0.11)。FTS组住院时间短于对照组,两者比较差异有统计学差异(WMD=-3.28,95%CI-4.74^-1.82,P<0.000 1)。满意度方面,二者比较的差异无统计学意义(RR=1.17,95%CI 0.84~1.64,P=0.35)。结论 FTS在乳腺癌患者围手术期中应用可能降低术后并发症,缩短住院时间,促进患者早日康复。
Objective To evaluate the safety and efficacy of fast track surgery（ FTS） in perioperative nursing for patients with breast cancer. Methods Two reviewers independently collected data about randomized controlled trials（ RCTs） which used FTS in perioperative nursing for patients with breast cancer from relative data bases,such as Wanfang,China National Knowledge Infrastructure（ CNKI）,VIP,China Biology Medicine disc（ CBMdisc）,Pubmed,Cochrane library,EMBASE. Jadad score was used to assess the quality of studies. Review Manager 5. 2 software was used to analyze the obtained data. Results Nine RCTs with a total of 995 patients were included. The results of the meta-analysis showed FTS significantly reduced the rate of total postoperative complications（ RR = 0. 59,95% CI 0. 41 - 0. 84,P = 0. 004）,especially the rate of upper limb edema（ RR = 0. 37,95% CI 0. 24 - 0. 57,P〈0. 000 01）,but there was no significant difference of the rate of the subcutaneous hydrops and flap necrosis（ RRsubcutaneous hydrops= 0. 73,95% CI 0. 40 - 1. 34,P = 0. 31;RRflap necrosis= 0. 55,95% CI 0. 26 - 1. 14,P = 0. 11）. The FTS group had shorter length of hospital stay than control group,and there was significant difference（ WMD =-3. 28,95% CI-4. 74 --1. 82,P〈0. 000 1）.For satisfaction,there was no significance between them（ RR = 1. 17,95% CI 0. 84 - 1. 64,P = 0. 35）.Conclusion FTS may reduce the postoperative complications and the length of hospital stay in perioperative nursing for patients with breast cancer,and make the patients recovered soon.
出处
《中国现代手术学杂志》
2016年第2期96-101,共6页
Chinese Journal of Modern Operative Surgery
