摘要目的 对肝癌介入术后早期与晚期下床活动减少术后并发症的安全性与舒适性进行系统评价,从而确定术后下床活动时间.方法 计算机检索PubMed、EMbase、Cochrane Library(2016年第2期),Web of Science、CBM、Wanfang数据库和CNKI数据库,搜集肝癌介入术后下床活动时间的研究/试验,检索时限均从建库至2016年9月10日.由2位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 5.0软件进行Meta分析.结果 共纳入9个研究,1164例患者.Meta分析结果显示:与术后卧床24 h后开始下床活动相比,术后12 h内早期下床活动方法在减少术后腰背疼痛[比值比(OR)=0.07,95%可信区间(CI)0.03~0.15,P<0.05]、排尿困难(OR=0.18,95%CI 0.10~0.33,P<0.05)、腹胀(OR=0.14,95%CI 0.07~0.29,P<0.05)、失眠(OR=0.15,95%CI 0.05~0.43,P<0.05)方面差异有统计学意义;但在减少穿刺局部不良反应,如淤血(OR=0.99,95%CI 0.45~2.18,P=0.98)、血肿(OR=0.90,95%CI 0.38~2.13,P=0.80)方面差异无统计学意义.结论 肝癌介入术后12 h早期下床活动能有效减少患者术后并发症的发生.受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证.

abstractsObjective To evaluate the safety and comfort of postoperative patients with hepatocellular carcinoma after interventional therapy in the early stage and late stage, so as to determine the time to get out of bed after operation. Methods We searched PubMed, EMbase, Cochrane Library (2016 second), Web of Science, CBM, Wanfang Data and CNKI database, collect test/ambulation time of hepatocellular carcinoma after interventional therapy were searched from inception to September 10, 2016. Meta analysis was performed by 2 reviewers independently by screening literature, extracting data and evaluating the risk of bias in the study. RevMan 5.0 software was used to analyze the data. Results A total of 9 studies were included in the study, and 1164 patients were included. The Meta analysis results showed that:compared with 24 hours in bed after operation, 12 hours early ambulation method to reduce postoperative pain, postoperative [odds radio (OR)=0.07, 95% confidence interval (CI) 0.03-0.15, P <0.05] and dysuria (OR =0.18, 95% CI 0.10-0.33, P < 0.05), abdominal distension (OR =0.14, 95% CI 0.07-0.29, P<0.05), insomnia (OR=0.15, 95% CI 0.05-0.43, P<0.05). But in the local punctura, such as congestion (OR=0.99, 95%CI 0.45-2.18, P=0.98), hematoma (OR=0.90, 95% CI 0.38-2.13, P=0.80), the difference was not statistically significant. Conclusions The available evidence indicates that the early postoperative 12 hours after interventional therapy can effectively reduce the incidence of postoperative complications. To be included in the quantity and quality of the research, the conclusion still need to carry out more high-quality research to be verified.