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中华老年骨科与康复电子杂志 ›› 2022, Vol. 08 ›› Issue (05) : 313 -320. doi: 10.3877/cma.j.issn.2096-0263.2022.05.010

Meta分析

加速康复外科理念在老年股骨颈骨折治疗过程中应用效果的meta分析
覃仁镭1,(), 罗显德1   
  1. 1. 530023 南宁,广西中医药大学第一附属医院东葛院区四肢骨伤科
  • 收稿日期:2021-03-15 出版日期:2022-10-05
  • 通信作者: 覃仁镭

The effect of enhanced recovery after surgery theory treating femoral neck fractures in elderly patients: a meta-analysis

Renlei Qin1,(), Xiande Luo1   

  1. 1. Department of Orthopedics and Traumatology, Dongge Hospital Area, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, China
  • Received:2021-03-15 Published:2022-10-05
  • Corresponding author: Renlei Qin
引用本文:

覃仁镭, 罗显德. 加速康复外科理念在老年股骨颈骨折治疗过程中应用效果的meta分析[J/OL]. 中华老年骨科与康复电子杂志, 2022, 08(05): 313-320.

Renlei Qin, Xiande Luo. The effect of enhanced recovery after surgery theory treating femoral neck fractures in elderly patients: a meta-analysis[J/OL]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2022, 08(05): 313-320.

目的

系统评价加速康复外科理念在老年股骨颈骨折治疗过程中的应用效果。

方法

检索中国知网、维普、万方、Pubmed、Embase等数据库等数据库研究加速康复外科与传统方法在老年股骨颈骨折中应用效果的随机对照试验文献,检索时间为各数据库建库至2019年12月。ERAS组采用加速康复外科理念指导治疗,对照组采用传统方法。RevMan 5.3软件进行文献质量评价和Meta分析。

结果

纳入7篇文献,共680例,ERAS组340例,对照组340例。Meta分析结果显示,与对照组比较,ERAS组可显著缩短住院时间(MD=-4.44;95% CI:-4.88,-4.01;P<0.001);减少术后并发症的产生(RR=0.29;95% CI:0.19,0.44;P<0.001);提高患者髋关节功能Harris评分(MD=4.86;95% CI:3.93,5.80;P<0.001);降低疼痛VAS评分(SMD=-1.83;95% CI:-3.23,-0.44;P=0.01)。

结论

ERAS理念应用于老年股骨颈骨折治疗中可有效缩短住院时间、减少并发症的发生,提高患者生活治疗,改善预后,值得在临床中推广。

Objective

To systematically evaluate the effect of ERAS theory applied in treating elderly patients with femoral neck fracture.

Methods

Randomized controlled trials (RCTs) on enhanced recovery after surgery(ERAS) theory peformed in elderly patients with femoral neck fracture were searched in recognized databases, such as CNKI、Wanfang、Weipu、Pubmed、Embase databases. The retrieval time was set up for each database up to December, 2019. The ERAS group is guided by the Enhanced Recovery After Surgery concept, and the control group is treated with the traditional methods. Literatures quality evaluation and meta analysis were performed using RevMan 5.3 software.

Results

A total of 7 RCTs were included in this study, with a total of 680 patients, of which 340 were in ERAS group and 340 in control group. The results of Meta analysis showed that compared with the control group, ERAS group could significantly shorten the length of stay in hospital (MD=-4.44; 95% CI: -4.88, -4.01; P<0.001). Reduce postoperative complications (RR=0.29; 95% CI: 0.19, 0.44; P<0.001); Increase the Harris score of hip function (MD = 4.86; 95% CI: 3.93, 5.80; P<0.001); Reduce the patient's pain VSA score (SMD =-1.83; 95% CI: -3.23, 0.44; P=0.01).

Conclusion

the application of ERAS concept in elderly patients withfemoral neck fractures can effectively shorten the length of stay, reduce the occurrence of complications, improve the life treatment of patients and improve the prognosis, which is worth popularizing in clinic.

图1 文献筛选流程图
表1 纳入7篇文献基本信息
图2~3 文献偏倚风险评估注:绿色(+):低风险;黄色(?):不清楚;红色(-):高风险
图7 ERAS组与对照组疼痛VAS评分比较
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