加速康复外科在全膝关节置换术中安全性及有效性的Meta分析

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摘要目的系统性评价加速康复外科(enhanced recovery after surgery，ERAS)在膝关节置换术中的安全性和有效性。方法检索Embase、Pubmed、ScienceDirect、Medine、Cochrane Library、中国知网、万方、维普等数据库，检索全膝关节置换术中ERAS的随机对照试验(randomized controlled trial，RCT)。Cochrane工具用于评估文献风险，RevMan 5.3及R3.6.2软件用于数据分析。结果共有6篇RCT的1 673例患者，其中ERAS组565例，对照组1 108例。分析显示，与对照组相比，ERAS组的住院时间显著缩短2.17 d(MD=－2.17，95%CI －3.36~0.99，P＜0.01)；ERAS组术后相关并发症发生率为9.1%，显著低于对照组28.9%(r＝0.30，95%CI 0.10~0.94，P＝0.02)。结论 ERAS在全膝关节置换术中的应用是安全有效的，能显著缩短住院时间，减少术后并发症，值得临床广泛推广。

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关键词 ：全膝关节置换术, 加速康复外科, Meta分析

Abstract：Objective To systematically evaluate the safety and effectiveness of accelerated rehabilitation surgery (enhanced recovery after surgery，ERAS) in total knee arthroplasty.Methods A randomized controlled trial (Randomized controlled trial，RCT) of ERAS in total knee arthroplasty was searched in Embase，Pubmed，Science Direct，Medline，Cochrane Library，CNKI，Wanfang，Vipp and other databases.Cochrane tool was used to evaluate the literature risk.RevMan 5.3 and R3.6.2 software were used for data analysis.Results A total of 1673 patients with 6 articles of RCT，were included，including 565 patients in ERAS group and 1108 patients in control group.Meta-analysis showed that compared with the control group.the hospitalization time of ERAS group was significantly shortened by 2.17 days (MD=－2.17，95%CI －3.36~0.99，P＜0.01).ERAS group was 9.1%，which was significantly lower than that of control group (r＝0.30，95%CI 0.10~0.94，P＝0.02).Conclusion The application of ERAS in total knee arthroplasty is safe and effective，which can significantly shorten the hospitalization time and reduce postoperative complications，which is worthy of extensive clinical promotion.

Key words： total knee arthroplasty enhanced recovery after surgery Meta-analysis

通讯作者: 关振鹏

作者简介: 贾俊秀(1982－ )，男，主治医师，北京大学首钢医院，100144。

引用本文:

贾俊秀，唐冲，张清华，刘家帮，裴征，关振鹏 *. 加速康复外科在全膝关节置换术中安全性及有效性的Meta分析[J]. 实用骨科杂志, 2020, 26(6): 499-503.
Jia Junxiu，Tang Chong，Zhang Qinghua，et al. Safety and Effectiveness of Enhanced Recovery after Surgery (ERAS) in Total Knee Arthroplasty：a Meta-Analysis. sygkzz, 2020, 26(6): 499-503.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2020/V26/I6/499

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