这项研究的目的是评估围手术期应用加速康复外科(ERAS)概念对接受骨科手术的患者伤口感染和术后并发症的影响,为术后护理提供理论依据。关于ERAS应用于接受骨科手术的患者的随机对照试验(RCT),截至2023年10月出版,在PubMed中确定,WebofScience,科克伦图书馆,Embase,万方,中国生物医学文献数据库和中国国家知识基础设施数据库。根据纳入和排除标准,由两名评审员筛选和评估文献。并从最终纳入的文章中提取数据。使用RevMan5.4软件分析数据。共有20项RCT纳入分析,其中包括1875名接受骨科手术的患者,其中938和937人在ERAS和对照组中,分别。分析显示,在接受骨科手术的患者中,围手术期实施ERAS与伤口感染率显着降低相关(1.6%vs.6.19%,风险比[RR]:0.30,95%置信区间[CI]:0.18-0.50,p<0.001)和并发症(5.12%vs.21.88%,RR:0.23,95%CI:0.17-0.32,p<0.001),并且可以有效缩短住院时间(标准化平均差[SMD]:-2.50天,95%CI:-3.17至-1.83天,p<0.001)与常规护理相比。现有证据表明,在骨科手术患者围手术期实施ERAS可有效降低伤口感染率和并发症,缩短住院时间,促进患者早日康复。
The aim of this study was to evaluate the effects of perioperative application of enhanced recovery after surgery (ERAS) concepts on wound infections and post-operative complications in patients receiving orthopaedic surgery, to provide a theoretical basis for post-operative care. Randomised controlled trials (RCTs) on the application of ERAS to patients receiving orthopaedic surgery, published up to October 2023, were identified in PubMed, Web of Science, Cochrane Library, Embase, Wanfang,
China Biomedical Literature Database and
China National Knowledge Infrastructure databases. Literature was screened and evaluated by two reviewers based on the inclusion and exclusion criteria, and data were extracted from the final included articles. Data were analysed using RevMan 5.4 software. A total of 20 RCTs were included in the analysis, which included 1875 patients undergoing orthopaedic surgery, of whom 938 and 937 were in the ERAS and control groups, respectively. The analysis revealed that in patients undergoing orthopaedic surgery, implementation of ERAS in the perioperative period was associated with a significantly reduced the rate of wound infections (1.6% vs. 6.19%, risk ratio [RR]: 0.30, 95% confidence interval [CI]: 0.18-0.50, p < 0.001) and complication (5.12% vs. 21.88%, RR: 0.23, 95% CI: 0.17-0.32, p < 0.001) and can effectively shorten the hospital length of stay (standardised mean difference [SMD]: -2.50 days, 95% CI: -3.17 to -1.83 days, p < 0.001) compared with that of conventional care. The available evidence suggests that the implementation of ERAS in the perioperative period of patients undergoing orthopaedic surgery could effectively reduce the rate of wound infections and complications, shorten the hospital length of stay and promote the early recovery of patients.