抗生素对肛周脓肿切开引流术后肛瘘形成影响的meta分析

Effect of antibiotics on anal fistula formation after perianal abscess incision and drainage:a meta-analysis

目的探讨肛周脓肿术后应用抗生素对肛瘘形成的影响。方法制订检索式检索Web of Science、PubMed、Embase、Cochrane Library、万方数据库、中国知网、维普数据库及中国临床试验注册中心数据,收集肛周脓肿切开引流术后应用抗生素治疗的临床研究,筛选及评价后进行meta分析。结果共计纳入8项研究,其中3项研究为随机对照试验,4项研究为队列研究,1项为病例对照研究;按照研究类型不同分成随机对照试验亚组和观察性研究亚组,采用随机效应模型合并分析。随机对照试验亚组meta分析结果RR=0.71,95%CI:0.30~1.69;观察性研究亚组meta分析结果RR=0.61,95%CI:0.48~0.78。总RR=0.64,95%CI:0.47~0.88。结论肛周脓肿切开引流术后抗生素的应用对肛瘘形成有一定的预防作用。

Objective To investigate the effect of antibiotics on the formation of anal fistula after perianal abscess surgery.Methods Database of Web of Science,PubMed,Embase,Cochrane Library,Wanfang,CNKI,VIP and China Clinical Trial Registry were searched to collect clinical studies on antibiotic therapy after perianal abscess incision and drainage,and meta-analysis was performed after screening and evaluation.Results A total of eight studies were included for systematic review,including three studies were randomized controlled trials,four studies were cohort studies,and one study was case-control study.They were divided into randomized the controlled trial(RCT)subgroup and the observational study subgroup according to different research types,and combined analysis was conducted by using random effects model.The risk ratio(RR)of RCT subgroup was 0.71,95%CI was 0.30-1.69;The RR of observational research subgroup was 0.61,95%CI was 0.48-0.78.The total RR was 0.64,95%CI was 0.47-0.88.Conclusion The application of antibiotics after perianal abscess incision and drainage has a certain preventive effect on the formation of anal fistula.