不同保温措施对腹部手术患者围术期低体温干预效果的网状Meta分析

Effect of thermal insulation measures on intervention of perioperative hypothermia in patients undergoing abdominal surgery:a network meta-analysis

目的通过网状Meta分析评价不同保温措施对腹部手术患者围术期低体温的干预效果。方法检索中国知网(CNKI),维普中文期刊服务平台(VIP),万方数据(Wan Fang Data),中国生物医学文献服务系统(SinoMed),PubMed,the Cochrane Library,Web of Science,Embase中不同保温措施对腹部手术患者围术期低体温干预效果的随机对照试验研究,检索时间均为建库至2023年9月1日。2名研究员根据纳入和排除标准,独立进行文献筛选、资料提取和质量评价。采用Revman 5.4、R 4.3.1和Stata17.0进行网状Meta分析。结果共纳入26项研究,涉及9种保温措施,共计2414例患者。结果显示,充气式保温毯联合加温冲洗在维持腹部手术患者围术期核心体温中效果最佳;充气式保温毯联合加温输液在减少患者围术期低体温和寒战发生率的效果最佳。结论现有证据表明,充气式保温毯联合加温冲洗/加温输液对腹部手术患者围术期低体温干预效果最佳。

Objective To evaluate the effectiveness of different thermal insulation measures on intervention of perioperative hypothermia in patients undergoing abdominal surgery,through a network Meta-analysis.Methods A systematic search through online databases was conducted from the inception of the databases to August 2023.Databases of CNKI,VIP,Wan Fang Data,SinoMed,PubMed,the Cochrane Library,Web of Science and Embase were searched to retrieve randomly controlled trials(RCTs)in the effectiveness of different thermal insulation measures on perioperative hypothermia in patients undergoing abdominal surgery.According to the inclusion and exclusion criteria,two researchers independently screened the retrieved literatures,extracted data and evaluated the quality of acquired data.Revman 5.4,R 4.3.1 and Stata17.0 were used for the network meta-analysis of the acquired data.Results A total of 26 RCTs were included,involving 9 thermal insulation measures that involved with 2414 patients.Meta-analysis showed that an inflatable blanket combined with warmed intravenous infusion achieved the best effectiveness in maintaining the perioperative core temperature of the patients with abdominal surgery.An inflatable blanket combined with warmed peritoneal lavage fluid achieved the best effectiveness in reduction of the incidence of perioperative hypothermia and shivering.Conclusion This study shows that a combination of inflatable blanket with warmed peritoneal lavage fluid/warmed intravenous infusion can achieve the best effectiveness on intervention of perioperative hypothermia in patients undergoing abdominal surgery.