手术室护理预防骨科术后感染的Meta分析

Meta-analysis of prevention of infection a fter orthopaedic suupgery by operating room nursing

目的:系统评价手术室护理干预预防骨科术后感染的疗效。方法:通过计算机检索Cochrane Library、VIP、CNKI、WanFang Data自建库以来~2018年7月发表的手术室护理干预预防骨科术后感染的随机对照试验,并采用Review Manager 5.3软件对纳入RCT进行Meta分析。结果:共纳入18篇文献,2946例患者。Meta分析结果:手术室护理干预后骨科术后感染率较常规护理显著下降,差异有统计学意义[OR=0.24,95%CI=(0.17,0.34);Z=7.79,P<0.00001],手术室护理干预较常规护理不规范操作发生率明显降低,差异有统计学意义[OR=0.22,95%CI=(0.14,0.35);Z=6.68,P<0.00001]。结论:现有的文献证据表明,手术室护理干预能有效降低骨科术后感染率及不规范操作发生率,但受研究数量偏少且质量偏低,尚需要更多高质量、大样本的随机对照试验对其疗效进一步加以证实。

Objective To evaluate the effects operating room nursing on the prevention of postoperative infection of orthopedics.Method The database of PubMed,VIP,CNKI and WanFang were comprehensively searched for the randomized controlled trials about operating room nursing on the prevention of postoperative infection of orthopedics,published before July 2018.The risk of bias was evaluated by Cochrane collaboration's tool,then the extracted data were analyzed by Review Manager 5.3 soft.Results Included 18 randomized controlled trials and 2 946 patients in this study.Meta-analysis results showed that:Compared with routine nursing,operating room nursing can significantly decrease the infection rate the different was statisticaly significant [OR=0.24,95% CI =(0.17,0.34);Z =7.79,P<0.000 01] and irregular operation rate the different was statistidly significant[OR=0.22,95% CI =(0.14,0.35);Z =6.68,P<0.000 01]. Conclusion Existing evidence suggested that operating room nursing could decrease postoperative infection of orthopedics,ho-wever,due to the limited quantity and quality of literatures,the results of above need to be confirm by more rigorous evidence.