■早期动员是增强术后恢复(ERAS)途径的重要组成部分之一,并已被证明可以减少并发症并优化患者预后。然而,早期动员对接受经股心导管插入术的患者的影响以及最佳动员时机的时间仍存在争议.我们旨在确定早期动员的安全性,并为接受股动脉心脏导管插入术的患者提供早期动员的最佳时机。
■我们搜索了MEDLINE,EMBASE,PubMed,WebofScience,系统评价的Cochrane数据库,CINAHL,Scopus,中国国家知识基础设施(CNKI),万方数据库,和中国科技期刊数据库(VIP)全面进行与早期动员相关的随机对照试验,探讨其对经股动脉心导管术后患者的影响。使用修订的Cochrane偏见风险工具(RoB2)和I2指数评估研究的偏倚和异质性风险。分别。采用综合Meta分析(CMA)进行Meta分析。
■我们确定了14项试验,共2653名参与者。早期活动与背痛的显着减少相关(平均差异(MD)=0.634,95%CI:0.23-1.038;p=0.002),尤其是在3h~4h与5h~6h(MD=0.737,95%CI:0.431-1.043;p=0.000)和12h与24h(OR=5.504,95%CI:1.646-18.407;p=0.006)接受早期动员指导的患者中。亚组分析的结果还显示,通过在12小时内早期动员与24小时相比,尿潴留的风险显着降低(OR=5.707,95%CI:1.859-17.521;p=0.002)类别。
■未发现早期活动会增加出血风险,血肿,假性动脉瘤,尿潴留,经股动脉心导管插入术后穿刺部位疼痛。早期动员是ERAS的一项实际举措,将动员时间提前到2h~4h可能是安全可行的。
UNASSIGNED: Early mobilization is one of the essential components of enhanced recovery after surgery (ERAS) pathways and has been shown to reduce complications and optimize patient outcomes. However, the effect of early mobilization for patients who undergo trans-femoral cardiac catheterization and the time for optimal mobilization timing remains controversial. We aimed to identify the safety of early mobilization and provide the optimum timing for early mobilization for patients undergoing trans-femoral cardiac catheterization.
UNASSIGNED: We searched MEDLINE, EMBASE, PubMed, Web of Science, Cochrane databases of systematic reviews, CINAHL, SCOPUS, China National Knowledge Infrastructure (CNKI), Wan Fang Database, and Chinese Science and Technology Periodical Database (VIP) comprehensively for randomized controlled trials associated with early mobilization, to explore its effects on patients after a trans-femoral cardiac catheterization. The risk of bias and heterogeneity of studies was assessed using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and I 2 index, respectively. The comprehensive Meta-analysis (CMA) was adopted to perform the meta-analysis.
UNASSIGNED: We identified 14 trials with 2653 participants. Early mobilization was associated with significant decrease in back pain (mean difference (MD) = 0.634, 95% CI: 0.23-1.038; p = 0.002), especially in patients receiving instruction for early mobilization in 3 h~4 h versus 5 h~6 h (MD = 0.737, 95% CI: 0.431-1.043; p = 0.000) and 12 h versus 24 h (OR = 5.504, 95% CI: 1.646-18.407; p = 0.006) categories. The results of subgroup analysis also showed a significant risk reduction in urinary retention by early mobilization in 12 h versus 24 h (OR = 5.707, 95% CI: 1.859-17.521; p = 0.002) category.
UNASSIGNED: Early mobilization has not been shown to increase the risk of bleeding, hematoma, pseudoaneurysm, urinary retention, and pain at the puncture site after trans-femoral cardiac catheterization. Early mobilization is a practical initiative in ERAS, and it may be safe and feasible to advance the mobilization to 2 h~4 h.