我国医疗机构成人手术患者手术获得性压力性损伤流行特征的Meta分析

The Epidemiological Characteristics of Intraoperatively Acquired Pressure Injuries in Adult Surgical Patients in Chinese Medical Institutions:A Meta-analysis

目的系统评价我国医疗机构成人手术患者手术获得性压力性损伤(intraoperatively acquired pressure injury IAPI)发生率及其流行特征。方法检索多个中英文数据库中关于手术患者IAPI发生率的研究,搜索时间为建库至2020年11月。应用Stata 12.0软件行Meta分析。结果最终纳入31篇文献(28492例患者,其中IAPI患者1962例)。Meta分析结果显示,IAPI总体发生率为12.2%(95%CI 10.3%~14.0%,P<0.01);亚组分析显示,女性、高龄、骨科、心血管外科、术中俯卧位、手术时长>2 h、急诊手术患者是IAPI的高发群体;髂嵴、肋缘、骶尾及肩胛等部位是IAPI的好发部位。结论不同特征人群IAPI发生率不同,上述特征的患者是重要防控目标,应定期监测,为指导手术患者压疮预防管理提供依据。

Objective To systematically evaluate the incidence of intraoperatively acquired pressure injury(IAPI)in adult surgical patients in Chinese medical institutions.Methods The studies of IAPI incidence in surgical patients from PubMed,Web of Science,Embase,Cochrane Library,CINAHL,China Biomedical Literature Database,CNKI,Wanfang and VIP database were searched by computer.The time range was from the establishment of the database to November 2020.Meta analysis was carried out by Stata 12.0.Results 31 articles were included in the study with 28492 patients and among whom there were 1962 IAPI patients.Meta analysis results showed that the overall incidence was 12.2%(95%CI=10.3%-14.0%,P<0.01).Subgroup analysis showed that female,elderly,orthopedic,cardiovascular surgery,intraoperative prone position,surgical duration longer than 2 hours,and emergency patients were the groups with high incidence of IAPI.The iliac crest,costal margin,sacral caudal and scapula are the most common sites of IAPI.Conclusions The incidence of IAPI should be monitored regularly to provide a basis for the prevention and management of pressure ulcers in surgical patients.