ABSTRACT
ObjectiveTo systematically review the efficacy and safety of fast-track surgery (FTS) in perioperative nursing for biliary calculi surgery. MethodsOnline databases of PubMed, Cochrane Library, CBM, CNKI, VIP, and Wanfang Data were comprehensively searched for relevant randomized controlled trials (RCTs). Potential bias was evaluated by Cochrane tools and data were analyzed by RevMan 5.3. ResultsA total of 11 RCTs with 1455 patients were included (738 cases in FTS group and 717 cases in control group). The results of meta-analysis showed that FTS significantly reduced the length of postoperative hospital stay (MD=-4.10, 95% CI: -5.68 to -2.52, P＜0.000 01) and hospital costs (MD=-0.47, 95%CI: -0.60 to -0.34, P＜0.000 01); meanwhile, FTS shortened the time to gastrointestinal recovery (SMD=-2.05, 95%CI: -2.84 to -1.27, P＜0.000 01), as well as the time to first defecation (SMD=-1.27, 95% CI: -2.08 to -0.46, P＜0.000 01). As for safety, FTS significantly reduced the total complications of choledocholithiasis (RR=0.53, 95%CI: 0.43-0.65, P＜0.000 01) and hepatolithiasis (RR=0.52, 95% CI: 0.35-0.77, P=0.001). ConclusionFTS is effective and safe in perioperative nursing for biliary calculi surgery. It can significantly reduce the length of postoperative hospital stay, enhance gastrointestinal recovery, shorten the time to first defecation, and reduce total complications.
ABSTRACT
ObjectiveTo systematically review the efficacy and safety of fast-track surgery (FTS) in perioperative nursing for biliary calculi surgery. MethodsOnline databases of PubMed, Cochrane Library, CBM, CNKI, VIP, and Wanfang Data were comprehensively searched for relevant randomized controlled trials (RCTs). Potential bias was evaluated by Cochrane tools and data were analyzed by RevMan 5.3. ResultsA total of 11 RCTs with 1455 patients were included (738 cases in FTS group and 717 cases in control group). The results of meta-analysis showed that FTS significantly reduced the length of postoperative hospital stay (MD=-4.10, 95% CI: -5.68 to -2.52, P＜0.000 01) and hospital costs (MD=-0.47, 95%CI: -0.60 to -0.34, P＜0.000 01); meanwhile, FTS shortened the time to gastrointestinal recovery (SMD=-2.05, 95%CI: -2.84 to -1.27, P＜0.000 01), as well as the time to first defecation (SMD=-1.27, 95% CI: -2.08 to -0.46, P＜0.000 01). As for safety, FTS significantly reduced the total complications of choledocholithiasis (RR=0.53, 95%CI: 0.43-0.65, P＜0.000 01) and hepatolithiasis (RR=0.52, 95% CI: 0.35-0.77, P=0.001). ConclusionFTS is effective and safe in perioperative nursing for biliary calculi surgery. It can significantly reduce the length of postoperative hospital stay, enhance gastrointestinal recovery, shorten the time to first defecation, and reduce total complications.
ABSTRACT
ObjectiveTo systematically evaluate the efficacy and safety of octreotide in the treatment of hepatocellular carcinoma (HCC). MethodsOnline databases including PubMed, Cochrane Library, Embase, China National Knowledge Internet, Wanfang Data, and China Science and Technology Journal Database were comprehensively searched for relevant randomized controlled trials (RCTs) of octreotide in the treatment of HCC. The quality of included studies was assessed using the method recommended by the Cochrane handbook for systematic review. A meta-analysis was performed by using RevMan 5.3.4 software. ResultsEleven RCTs were included, which involved 909 cases (treatment group, 452 cases; control group, 457 cases). As for clinical efficacy, octreotide significantly increased the response rate (RR=2.30, 95% CI: 1.25~4.22, P=0.007) and decreased the progression rate (RR=0.78, 95% CI: 0.59~1.04, P=0.09), but there was no significant difference in disease control rate and progression rate between the two groups (P＞0.05). The overall survival rate and 6-month, 1-year, and 2-year survival rates in the treatment group were not significantly higher than those of the control group (all P＞0.05). As regards to safety, severe adverse events in the treatment group were significantly reduced (RR=0.72, 95% CI: 0.54~0.98, P=0.03), but there were no significant differences in diarrhea, nausea/vomiting, liver function abnormality, and blood glucose fluctuation between the two groups (all P＞0.05). ConclusionFor HCC patients, octreotide can significantly increase the clinical response rate incidence of grade 3/4 adverse events, but it does not lead to significant improvement in disease progression and survival rate.
ABSTRACT
Objective To analyze and study the implication of dynamic changes in plasma CD62P among patients with obstructive jaundice and cholecystolithiasis.Methods A total of 58 patients diagnosed with choledocholithiasis and jaundice were included in the obstructive jaundice group,and 50 patients were in the cholecystolithiasis group.Peripheral venous blood was collected on preoperative day 3,on opera-tive day,and on postoperative days 3,6,9,12,15,18,and 21 in two groups,and the concentrations of plasma CD62P were measured by ELISA.Comparison of continuous data between the two groups was made by t test.Results The concentrations of plasma CD62P from preop-erative day 3 to postoperative day 18 were significantly higher in the obstructive jaundice group than in the cholecystolithiasis group (P<0.01 across all time points).In the cholecystolithiasis group,the concentrations of plasma CD62P significantly increased on operative day, and the increase continued and reached the peak on postoperative day 3,then followed by a decrease down to the preoperative level on post-operative day 9.In the obstructive jaundice group,the concentrations of plasma CD62P reached the peak on postoperative day 9,followed by a gradual decrease down to the preoperative level on postoperative day 18 and to an even lower level (preoperative level of patients with cho-lecystolithiasis)on postoperative day 21.Conclusion Extrahepatic biliary obstruction may lead to endothelial cell injury and platelet acti-vation,the condition of which is improved with the relief of obstruction.The surgery for obstructive jaundice may lead to much more endothe-lial cell injury and higher platelet activation than that for cholecystolithiasis.
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Objective To analyse the significance and relation between soluble P-selectin (sP-selectin),D-dimer (D-d) and endotoxin (ET) in the patient with obstructive jaundice (OJ). Methods Blood plasma sP-selectin and D-d in OJ group,acute cholecystitis group and healthy group were detected by ELISA and ET was detected by the colorimetric method, Results In healthy group,the concentration of blood plasma sP-selectin was ( 93.43 ? 17.65 ) ng/ml,ET(0.0030?0.0004)EU/ml,and D-d(0.39?0.21)mg/L; in acute cholecystitis group,sP-selectin was (233.32?82.12) ng/ml, ET(0.4012?0.1506) EU/ml,and D-d(0.76?0.27)mg/L; in OJ group,sP-selectin was (351.90?93.83) ng/ml ,ET (0.3814?0.1430)EU/ml,and D-d(2.14?0.37)mg/L.The sP-selectin, D-d and ET in the acute cholecystitis group and the OJ group were higher than those in healthy group (P 0.05). sP-selectin and D-d in the OJ group were significantly higher than that in the acute cholecystitis group (P