手术病人体质指数对术中获得性压力性损伤发生影响的Meta分析

Influence on body mass index on the occurrence of intraoperative acquired pressure injury in surgical patients:a Meta-analysis

目的:系统评价手术病人的体质指数(BMI)对术中获得性压力性损伤的影响。方法:计算机检索PubMed、EMbase、CINAHL、the Cochrane Library、中国生物医学文献数据库(CBM)、万方医数据库(WanFang Data)、中国知网(CNKI)、维普网数据库(VIP)等,检索关于手术病人BMI对术中获得性压力性损伤影响的病例对照研究、队列研究,检索时限均为建库至2021年2月20日。由2名研究人员按纳入与排除标准独立筛选文献、提取资料、评估文献质量,并采用RevMan 5.4进行Meta分析。结果:纳入9篇文献,共计10360例病人。Meta分析结果显示,手术病人的BMI是术中获得性压力性损伤形成的相关因素,病人BMI超重及以上(包括亚洲标准BMI≥23 kg/m^(2)和中国标准BMI>24 kg/m^(2)的病人)[OR=0.62,95%CI(0.48,0.80),P=0.0002]是保护因素。结论:现有证据表明,BMI与术中获得性压力性损伤的形成有关,与BMI超重及以上的手术病人相比,BMI正常及以下的手术病人更易发生术中获得性压力性损伤。此外,纳入的文献中没有证据表明手术病人BMI>30 kg/m^(2)是否会增加术中获得性压力性损伤的风险,因此仍需高质量的队列研究进行进一步论证。

Objective:To systematically evaluate the influence on BMI of intraoperative acquired pressure injury.Methods:Case-control studies and Cohort studies on the effect of BMI of surgical patients on intraoperative acquired pressure injury were searched from PubMed,EMbase,CINAHL,the Cochrane Library,CBM,WanFang Data,CNKI,VIP,the retrieval time was from inception to February 20,2021.Two researchers independently screened the literature according to the inclusion and exclusion criteria,extracted datas,assessed the quality of the literature,and RevMan 5.4 was used for Meta-analysis.Results:A total of nine studies were included,involving 10657 patients.Meta-analysis results showed that BMI was a related factor in the formation of intraoperative acquired pressure injury,patients with BMI overweight or above(including patients with Asian standard BMI≥23 kg/m^(2) and Chinese standard BMI>24 kg/m^(2))[OR=0.62,95%CI(0.48,0.80),P=0.0002]were protective factors.Conclusions:Current evidence shows that BMI is related to the formation of intraoperative acquired stress injury.Compared with surgical patients with overweight or above BMI,surgical patients with normal BMI or below are more prone to have intraoperative acquired stress injury.In addition,there is no evidence in the included literature showed that whether BMI of surgical patients>30 kg/m^(2) will increase the risk of intraoperative acquired stress,and it still needs to be further confirmed by high-quality cohort studies.