摘要
目的探讨预康复对结直肠癌患者术后临床结局的影响。方法检索PubMed、Embase、Cochrane Library、Web of Science数据库,检索时限从各数据库建库至2023年3月。收集预康复对结直肠癌手术患者影响的相关文献,由2名研究者对纳入文献独立进行质量评价。采用RevMan5.3软件对术后总并发症发生率,首次肛门排气时间,胃肠功能障碍、肺炎、术后吻合口瘘发生率,住院时间及病死率等指标进行分析。结果纳入文献共13篇,总样本量为8311例,其中预康复组3033例,对照组5278例。meta分析结果显示,预康复组术后总并发症发生率低于对照组(OR=0.55,95%CI 0.39~0.77,P<0.05),术后首次肛门排气时间短于对照组(WMD=-0.70,95%CI-1.29~-0.11,P<0.05),胃肠功能障碍发生率低于对照组(OR=0.53,95%CI 0.43~0.65,P<0.05);两组患者术后肺炎和吻合口瘘发生率、住院时间及病死率差异均无统计学意义(均P>0.05)。结论预康复可降低结直肠癌患者术后总并发症发生率,缩短术后首次肛门排气时间及减少胃肠功能障碍的发生,有助于改善患者临床结局。
Objective To explore the effect of prehabilitation on the clinical outcomes after surgery of patients with colorectal cancer.Methods The PubMed,Embase,Cochrane Library,and Web of Science were searched to collect relevant literatures of the effects of prehabilitation for patients undergoing colorectal cancer surgery from their establishment to March,2023.Two reviewers independently evaluated the quality of the included studies.The RevMan 5.3 software was used for the meta-analysis of the total incidence of postoperative complications,time to first anal exhaust,incidences of gastrointestinal dysfunction,pneumonia,and anastomotic leakage,hospital stay,and mortality.Results A total of 13 articles with a sample size of 8311 cases were enrolled,including 3033 cases in the prehabilitation group and 5278 cases in the control group.The meta-analysis results showed that the prehabilitation group had a lower incidence of postoperative complications(OR=0.55,95%CI 0.39-0.77,P<0.05),shorter time to first anal exhaust(WMD=-0.70,95%CI-1.29 to-0.11,P<0.05),and a lower incidence of gastrointestinal dysfunction(OR=0.53,95%CI 0.43-0.65,P<0.05)than the control group.There were no statistical differences in the incidences of postoperative pneumonia and anastomotic leakage,hospital stay,and mortality between the two groups(all P>0.05).Conclusion Prehabilitation can reduce the total incidence of postoperative complications in patients with colorectal cancer,shorten the time to first anal exhaust,decrease the incidence of gastrointestinal dysfunction,and improve their clinical outcomes.
作者
张凯思
马金栋
张启慧
陈强谱
Zhang Kaisi;Ma Jindong;Zhang Qihui;Chen Qiangpu(Department of General Surgery,Binzhou Medical University Hospital,Binzhou 256600,China;Department of Clinical Nutrition,Binzhou Medical University Hospital,Binzhou 256600,China)
出处
《国际医药卫生导报》
2024年第3期367-373,共7页
International Medicine and Health Guidance News
基金
山东省胆胰肿瘤临床精品特色专科(SLCZDZK-2401)
山东省省级临床重点专科学科(SLCZDZK-0701)。
关键词
结直肠癌
预康复
结直肠外科
术后并发症
META分析
Colorectal cancer
Prehabilitation
Colorectal surgery
Postoperative complications
Meta-analysis
