庆大霉素浸泡液预防膝关节交叉韧带重建术后感染疗效的meta分析

A meta-analysis of the effect of gentamicin immersion solution on prevention of infection after knee cruciate ligament reconstruction

目的:通过系统分析评价庆大霉素溶液浸泡移植肌腱在预防膝关节交叉韧带重建术后感染的疗效,以期为临床应用提供循证参考。方法:通过计算机查阅中国知网、万方数据库、PubMed、Embase、The Cochrane Library等,搜集有关庆大霉素浸泡液预防膝关节交叉韧带重建术后感染的疗效的临床研究,检索时间为建库至2021年8月,由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,使用RevMan 5.3软件进行meta分析。结果:共纳入3篇队列研究和1篇随机对照研究,包括4461例患者。Meta分析结果显示整体的交叉韧带感染率为0.9%,仅使用生理盐水浸泡冲洗肌腱感染率为2.0%,使用庆大霉素溶液浸泡后感染率为0.18%,使用庆大霉素溶液组明显优于使用生理盐水组(OR=0.09,95%CI:0.03~0.24,P<0.001)。结论:现有证据表明庆大霉素溶液浸泡肌腱能够降低膝关节交叉韧带重建术后感染率,但限于纳入文献的数量及质量,此结论可能还需更多的高质量研究予以验证。

Objective:To evaluate the efficacy of gentamicin immersion solution in tendon transplantation on preventing infection after knee cruciate ligament reconstruction through meta analysis,and to provide evidence-based reference for clinical practice.Methods:CNKI,Wanfang database,PubMed,Embase and The Cochrane Library were searched to collect clinical studies on the efficacy of gentamicin soak solution on preventing infection after knee cruciate ligament reconstruction.The retrieval period was from the establishment of the database to August 2021.Two researchers independently screened the literatures,extracted the data,and evaluated the risk of bias in the included studies.Meta-analysis was performed using RevMan 5.3 software.Results:A total of 3 cohort studies and 1randomized controlled study,including 4461 patients were included.Meta-analysis results showed that the overall infection rate of the cruciate ligament was 0.9%,the infection rate of the irrigated tendon with saline was 2.0%,and the infection rate of the irrigated tendon with gentamicin solution was reduced to 0.18%,which was significantly better than that of the saline group(OR=0.09,95%CI:0.03-0.24,P<0.001).Conclusions:Existing evidence suggests that gentamicin solution soaked tendon can reduce the infection rate during knee cruciate ligament reconstruction,but due to the quantity and quality of the included literatures,this conclusion may need to be verified by more high-quality studies.