發(fā)布時(shí)間：2018-06-11 19:39

  本文選題：手術(shù)部位感染 + 脊柱手術(shù)　； 參考：《中國(guó)脊柱脊髓雜志》2017年08期

【摘要】：目的 :系統(tǒng)評(píng)價(jià)中國(guó)人群脊柱術(shù)后手術(shù)部位感染(surgical site infection,SSI)的危險(xiǎn)因素,為臨床制定脊柱術(shù)后SSI的預(yù)防控制措施提供參考依據(jù)。方法:計(jì)算機(jī)檢索Pub Med(1966年1月~2017年5月)、EMBASE(1974年1月~2017年5月)、Cochrane Library(2017年5期)、CNKI(1994年1月~2017年5月)、CBM(1979年1月~2017年5月)、維普(1989年1月~2017年5月)和萬(wàn)方數(shù)據(jù)庫(kù)(1982年1月~2017年5月),納入關(guān)于中國(guó)人群脊柱術(shù)后SSI發(fā)生危險(xiǎn)因素的病例-對(duì)照研究,檢索時(shí)限均從建庫(kù)至2017年5月。兩名作者分別進(jìn)行文獻(xiàn)檢索、資料提取(包括研究地點(diǎn)、研究時(shí)間、樣本量、年齡、診斷、手術(shù)方式以及暴露因素)以及運(yùn)用Newcastle-Ottawa Scale(NOS)質(zhì)量評(píng)價(jià)量表進(jìn)行質(zhì)量評(píng)價(jià)。采用RevMan 5.3軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:共納入29篇文獻(xiàn),包括18486例患者,其中感染組932例,對(duì)照組17554例。根據(jù)NOS文獻(xiàn)質(zhì)量評(píng)價(jià)標(biāo)準(zhǔn)進(jìn)行質(zhì)量評(píng)價(jià),A級(jí)文獻(xiàn)19篇,B級(jí)文獻(xiàn)10篇。Meta分析結(jié)果顯示,與中國(guó)人群脊柱術(shù)后SSI發(fā)生相關(guān)的危險(xiǎn)因素有:性別(男性)[OR=1.33,95%CI(1.08,1.64),P0.05]、年齡(60歲)[OR=1.44,95%CI(1.01,2.04),P0.05]、肥胖[OR=2.64,95%CI(1.35,5.15),P0.05]、糖尿病[OR=3.86,95%CI(2.68,5.55),P0.05]、感染史[OR=6.64,95%CI(1.29,34.29),P0.05]、美國(guó)麻醉醫(yī)師協(xié)會(huì)(American Society of Anesthesiologists,ASA)評(píng)分(2分)[OR=2.72,95%CI(1.38,5.38),P0.05]、尿失禁[OR=6.32,95%CI(3.40,11.76),P0.05]、腦血管疾病[OR=5.73,95%CI(1.62,20.35),P0.05],同種異體骨植骨[OR=3.02,95%CI(1.09,8.34),P0.05]、手術(shù)時(shí)間(3h)[OR=3.44,95%CI(1.92,6.13),P0.05]、失血量(1000ml)[OR=2.40,95%CI(1.73,4.77),P0.05]、輸血[OR=2.61,95%CI(1.36,5.01),P0.05]、融合節(jié)段(3個(gè))[OR=2.23,95%CI(1.55,3.23),P0.05]、沒(méi)有預(yù)防性使用抗生素[OR=5.43,95%CI(2.66,11.08),P0.05]、術(shù)中參觀人員[OR=2.28,95%CI(1.19,4.37),P0.05]。結(jié)論 :男性、年齡60歲、肥胖、糖尿病、感染史、ASA評(píng)分2分、尿失禁、腦血管疾病、同種異體骨植骨、手術(shù)時(shí)間3h、失血量1000ml、輸血、融合節(jié)段3個(gè)、沒(méi)有預(yù)防性使用抗生素、術(shù)中參觀人員均為國(guó)人脊柱術(shù)后發(fā)生SSI的危險(xiǎn)因素。
[Abstract]:Objective: to evaluate the risk factors of surgical site infection of spinal site in Chinese population, and to provide reference for clinical prevention and control of postoperative site. Methods: computer search of Pub Mede (January 1966-May 2017) and Wanfang database (January 1982-May 2017) and Cochrane Library (January 1974-May 2017) and CBM (January 1979-May 2017) and Wanfang Database (January 1982-2017) May May, a case-control study on SSI risk factors after spinal surgery in Chinese population, The time limit for retrieval is from the construction of the database to May 2017. The two authors carried out literature retrieval, data extraction (including research location, study time, sample size, age, diagnosis, surgical methods and exposure factors) and quality evaluation scale using Newcastle-Ottawa scale. The software Revman 5.3 was used for statistical analysis. Results: a total of 29 articles were included, including 18486 patients, including 932 cases in the infection group and 17554 cases in the control group. According to the evaluation criteria of NOS literature quality, 19 articles of Grade A and 10 articles of Grade B were analyzed by Meta-analysis. 涓庝腑鍥戒漢緹よ剨鏌辨湳鍚嶴SI鍙戠敓鐩稿叧鐨勫嵄闄╁洜绱犳湁:鎬у埆(鐢鋒，

本文編號(hào)：2006427