预防性应用抗生素对腹股沟无张力疝修补术切口感染疗效的Meta分析

Antimicrobial prophylaxis in the prevention of incisional infection after tension-free inguinal hernioplasty： a meta-analysia

目的系统评价预防性应用抗生素对腹股沟无张力疝修补术后切口感染的作用。方法检索1975年12月至2012年10月公开发表的所有预防性使用抗菌药物对腹股沟无张力疝修术切口感染影响的随机对照试验，进行荟萃分析及系统评价。结果筛选符合纳入标准的随机对照试验11项，共4159例患者；共有130例发生切口感染，感染率为3．13％。其中预防性应用抗生素组1845例，有例45发生切口感染，感染率为1．94％；对照组2314例，有85例发生切口感染，感染率为3．67％。与对照组相比，预防性使用抗菌药物组可以减少手术部位感染（OR0．55，95％C10．38～0．80，P=0．002）。结论行腹股沟疝无张力修补术的患者，术前预防性使用抗生素能有效降低切口感染率。

Objective We conducted a systematic review and meta-analysis of the published literature to evaluate the efficacy of prophylactic antibiotics in the prevention of incisional infection of inguinal tension-free hernioplasty. Methods Articles of randomized controlled trials about the efficacy of prophylactic antibiotics in the prevention of incisional infection in the inguinal tension-free bernioplasty published from January 1975 to October 2012 was retrieved and systematically reviewed. Results A total of 11 randomized controlled trials meeting the inclusion criteria were screened. Among the 4159 cases of patients, 130 cases had wound infection, and the infection rate was 3.13%. In the prophylactic antibiotics group of 1845 cases, wound infection occurred in 45 cases; the infection rate was 1.94%. In the control group of 2314 cases, 85 cases had incision infection; the infection rate was 3.67%. The preventive use of antimicrobial drugs reduced surgical site infection of inguinal tension-free hernioplasty （ OR 0. 55, 95% CI 0. 38-0. 80, P = 0. 002）. Conclusions The use of prophylactic antibiotics can effectively reduce the incisional infection in the inguinal tension-free hernioplasty.