皮下持续负压引流术对我国结直肠癌病人术后切口愈合影响的Meta分析

Effect of subcutaneous continuous negative pressure drainage on postoperative wound healing in patients with colorectal cancer in China:a Meta-analysis

目的:研究国内应用皮下持续负压引流术对结直肠癌病人术后腹部切口愈合的影响。方法:检索2010年—2020年间中国知网、万方数据库、中国生物医学文献数据库和维普数据库中有关皮下持续负压引流术与传统常规换药术对结直肠癌病人术后切口恢复影响的文献,按照标准严格筛选并纳入合格的文献,利用RevMan 5.3软件做统计学分析。结果:共纳入10篇文献,Meta分析结果显示:与实施传统常规换药术病人比较,实施皮下持续负压引流术病人的切口感染[OR=0.17,95%CI(0.09,0.30),P<0.01]、切口裂开[OR=0.19,95%CI(0.06,0.54),P<0.01]、切口脂肪液化[OR=0.19,95%CI(0.12,0.32),P<0.01]发生率较低,切口平均换药次数[WMD=-2.18,95%CI(-2.89,-1.47),P<0.01]、术后住院时间[WMD=-1.72,95%CI(-2.71,-0.73),P<0.01]以及切口愈合时间[WMD=-2.95,95%CI(-3.56,-2.33),P<0.01]较短,且病人术后切口的甲级愈合率[OR=4.35,95%CI(2.87,6.59),P<0.01]较高。结论:现有证据表明,皮下持续负压引流术在结直肠癌病人术后切口愈合并发症发生率低,切口愈合时间短,本结论受纳入研究数量和质量的影响,仍然需要更大样本的临床随机对照研究进一步验证。

Objective:To study the effect of subcutaneous continuous negative pressure drainage on postoperative abdominal incision healing in patients with colorectal cancer.Methods:Literature on effect of subcutaneous continuous negative pressure drainage and traditional dressing change on postoperative incision recovery of patients with colorectal cancer was searched from CNKI,WanFang Database,CBM and VIP from 2010 to 2020.The qualified literature was strictly screened and included according to the standards,and RevMan 5.3 software was used for statistical analysis.Results:A total of 10 articles were included.Meta-analysis results showed that compared with patients undergoing conventional dressing change,patients undergoing subcutaneous continuous negative pressure drainage had lower incidence in incision infection[OR=0.17,95%CI(0.09,0.30),P<0.01],incision dehisce[OR=0.19,95%CI(0.06,0.54),P<0.01],incision fat liquefaction[OR=0.19,95%CI(0.12,0.32),P<0.01].Incision average switching frequency[WMD=-2.18,95%CI(-2.89,-1.47),P<0.01],postoperative hospitalization time[WMD=-1.72,95%CI(-2.71,-0.73),P<0.01],and incision healing time[WMD=-2.95,95%CI(-3.56,-2.33),P<0.01] were shorter,and The grade A healing rate of postoperative incision was higher[OR=4.35,95%CI(2.87,6.59),P<0.01].Conclusion:Current evidences show that subcutaneous continuous negative pressure drainage has a low incidence of postoperative wound healing complications in patients with colorectal cancer,and the wound healing time is short.This conclusion is affected by the quantity and quality of included studies,so it still needs to be further verified by larger clinical randomized controlled studies in the future.