中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
Chinese Journal of General Surgery
2015年
10期
808-812
,共5页
胃肿瘤%胃切除术%Meta分析
胃腫瘤%胃切除術%Meta分析
위종류%위절제술%Meta분석
Stomach neoplasms%Gastrectomy%Meta-analysis
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、Cochrane library、Web ofscience数据库关于FTS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RevMan 5.0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=0.000 2]、住院费用减少[SMD=-0.67,95％ CI(-1.00,-0.34),P＜0.000 1],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 FTS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.
目的 繫統評價快速康複外科(fast track surgery,FTS)在胃癌切除術中應用的安全性和有效性.方法 計算機檢索1994年1月至2014年3月Pubmed、Medline、Cochrane library、Web ofscience數據庫關于FTS在胃癌切除術中應用的隨機對照實驗(RCT)或臨床對照實驗(CCT),併輔用Google進行手工檢索,對符閤標準的文獻採用RevMan 5.0軟件進行Meta分析.結果 5組RCT和2組CCT納入研究,共有636例患者,其中FTS組309例,對照組327例.Meta分析結果顯示:FTS組較對照組術後腸道通氣時間提前[WMD=-18.74,95％ CI(-34.31,-3.17),P＜0.05]、住院時間減少[WMD=-2.46,95％ CI(-3.75,-1.17),P=0.000 2]、住院費用減少[SMD=-0.67,95％ CI(-1.00,-0.34),P＜0.000 1],但在手術時間、術中齣血量、術中淋巴結清掃數目、導尿管拔除時間及併髮癥髮生率方麵相比差異均無統計學意義(均P＞0.05).結論 FTS在胃癌切除術中應用能夠促進術後腸道功能恢複、縮短住院時間和減少住院費用,從而加速患者康複齣院.
목적 계통평개쾌속강복외과(fast track surgery,FTS)재위암절제술중응용적안전성화유효성.방법 계산궤검색1994년1월지2014년3월Pubmed、Medline、Cochrane library、Web ofscience수거고관우FTS재위암절제술중응용적수궤대조실험(RCT)혹림상대조실험(CCT),병보용Google진행수공검색,대부합표준적문헌채용RevMan 5.0연건진행Meta분석.결과 5조RCT화2조CCT납입연구,공유636례환자,기중FTS조309례,대조조327례.Meta분석결과현시:FTS조교대조조술후장도통기시간제전[WMD=-18.74,95％ CI(-34.31,-3.17),P＜0.05]、주원시간감소[WMD=-2.46,95％ CI(-3.75,-1.17),P=0.000 2]、주원비용감소[SMD=-0.67,95％ CI(-1.00,-0.34),P＜0.000 1],단재수술시간、술중출혈량、술중림파결청소수목、도뇨관발제시간급병발증발생솔방면상비차이균무통계학의의(균P＞0.05).결론 FTS재위암절제술중응용능구촉진술후장도공능회복、축단주원시간화감소주원비용,종이가속환자강복출원.
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 FTS was used in gastrectomy for gastric cancer between January 1994 and march 2014, and manual retrieval in Google.Using RevMan5.0 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.Meta-analysis showed: the FTS 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.
