两种备皮方式对中国胸腹部择期手术效果的系统评价

Systematic Evaluation of Elective Operative Efficacies for Thoracabominal Surgeries Based on Two Preserved Skin Methods

目的:用系统评价方法探讨国内胸腹部手术术前不剃毛备皮与剃毛备皮的效果比较.方法:通过检索CNKI数据库、维普数据库、CBM数据库、万方数据库收集所有与胸腹部术前备皮有关的文献,按Cochrane系统评价方法评价纳入研究质量,并使用RevMan 5.0软件进行Meta分析.结果:共纳入11篇文章,其中随机对照试验8篇,半随机对照试验1篇,历史回顾性研究2篇.Meta分析结果显示:剃毛备皮与不剃毛备皮相比,术后切口感染率[OR=0.37,95%CI(0.27,0.50),P<0.0001]具有统计学意义、术后细菌培养阳性率[OR=0.76,95%CI(0.43,1.32),P=0.32]和术后患者发热率[OR=0.82,95%CI(0.40,1.67),P=0.59]两项无统计学意义.另外两项纳入指标:护士工作量及病人舒适程度在纳入的论文中并没有定量的叙述,但定性分析表明,不剃毛备皮可以减轻护士工作量,使病人更舒适.结论:现有证据表明,不剃毛备皮可以就降低术后切口感染率,在术后细菌培养,术后发热并无影响,同时不剃毛备皮可以减少护士工作量,减轻病人的紧张程度,增加病人的舒适感.

Objective To discuss the systematic evaluation method of domestic metal- studded of this essay is to study the effect of preoperative hair non- shaving over using hair removal method for skin preparation. Methods The author has searched CNKI database,VIP database,Wan Fang thesis database for( relevant studies) / collecting all essays on preoperative skin preparation by abnominal and chest which published during 1990-2010. The author independently assessed the methodological quality of included trials,and extracted data according to Cochrane system evaluation. Meta- analysis was performed by RevMan 5. 0 software. Results there are 11 thesis included in all,among which 8 papers are extracted according to Randomized Controlled trial,one with Half a randomized controlled trial and 2 papers are the revive for history research. The results of meta-analyses showed that compared to preoperative hair non- shaving,the incision infection rate of hair removal method for skin preparation after an operation is of statistical significance,while Postoperative germ culture positive,and postoperative patients heating rate are not Statistically Significant( NSS). Another two indexes the nurse workload and Patient comfort levels are with no quantitative description,but according to qualitative investigation,preoperative hair non- shaving can lighten the nurse workload and make patients more comfortable. Conclusion Judging from the reams of evidence presented,hair non- shaving method for skin preparation can decrease postoperative incision infection rates,without negative effects on postoperative germ culture and postoperative fever. In the meantime,this method can also reduce the workload of the nurse,relieve the strain degree of patients and increase the comfortable sensation of patients.