摘要目的 系统评价术后快速康复(Enhanced Recovery After Surgery,ERAS)护理理念在食管癌围术期中应用效果及抗炎作用.方法 计算机检索PubMed、Embase、The Cochrane Database、护理学数据库(CI-NAHL)、中国生物医学数据库(CBM)、WanFang Data、维普和中国期刊全文数据库(CNKI),查找ERAS护理理念应用在食管癌治疗围术期效果的随机对照实验(Randomized Controlled Trial,RCT),检索时限:1997年1月～2016年12月.由2名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析.结果 共纳入12个RCT,包括1402例患者.Meta分析结果显示:与传统护理相比,ERAS护理能缩短食管癌手术患者的首次肛门排气时间,合并的均数差及95％CI为-19.39(-30.32,-8.45),Z=3.48,,差异有统计学意义(P<0.001);减少术后住院时间,合并的均数差及95％CI为-2.94(-3.89,-1.99),Z=6.07,差异有统计学意义(P<0.001);降低术后并发症发生率,合并的RR值及95％CI为0.53(0.41,0.68),Z=4.92,,差异有统计学意义(P<0.001);IL-6水平比较,MD=-1.77,95％CI(-1.16,-0.52),差异有统计学意义(P<0.001).结论 ERAS护理能缩短食管癌手术患者的首次肛门排气时间,减少术后住院时间和住院费用,降低术后并发症发生率,ERAS加速食管癌患者术后康复的原因可能与其抗炎作用相关.

abstractsObjective To systematicly evaluate the effect of enhanced recovery after surgery ( ERAS) nursing on patients with esophageal cancer surgery and its anti-inflammatory. Methods PubMed, Embase, The Cochrane Da-tabase, CINAHL, CBM, WanFang Data, VIP and CNKI was searched by computer. The randomized controlled trials ( RCT) in terms of effect of ERAS nursing applied in the treatment of esophageal cancer was sorted out and the retrieval duration was from January 1997 to December 2016. 2 reviewers independently screened the literatures, extracted the data and evaluated the risk of bias in the and then Meta analysis was conducted by the RevMan 5. 3. Results A total of 12 RCTs were included, including 1402 patients. The results of Meta-analysis showed that compared with traditional nursing, the ERAS nursing could shorten the time of the first anal discharge in patients with esophageal cancer, and the mean difference and 95％CI was -19. 39 (-30. 32 , -8. 45 ) , Z=3. 48 , and the difference was statistically significant (P<0. 001), reduce postoperative hospital stay, and the mean difference and 95％CI was -2. 94 (-3. 89, -1. 99), Z=6. 07 , and the difference was statistically significant ( P<0. 001 ) , reduce the incidence of postoperative complica-tions, the RR value of merger and 95％CI was 0. 53 (0. 41, 0. 68), Z=4. 92, and the difference was statistically sig-nificant ( P<0. 001 ) . There were significant differences in IL-6 levels MD=-1. 77 , 95％CI (-1. 16 , -0. 52 ) , ( P<0. 001) . Conclusions ERAS nursing can shorten the time of first anal exhaust, shorten the length of stay and cost of hospitalization, reduce the incidence of postoperative complications, and the role of ERAS may be related to its anti-in-flammatory effect.