延期缝合对比一期缝合处理阑尾炎污染切口的Meta分析  

Delayed Primary Closure versus Primary Closure for Treating the Contamination of the Incision in Patients with Appendicitis:A Meta-analysis

作　　者：郭继武[1,2] 郭琦[1] 周元媛[1,2] 吴佳[1,2] 张宇龙[1,2] 马彬[1] 

机构地区：[1]兰州大学基础医学院循证医学中心,兰州730000 [2]兰州大学第二临床医学院普外科,兰州730030

出　　处：《中国医科大学学报》2011年第3期274-276,281,共4页Journal of China Medical University

基　　金：兰州大学中央高校基本科研业务费专项资金资助(lzujbky-2009-t12)

摘　　要：目的系统评价延期缝合对比一期缝合处理阑尾污染切口的临床疗效。方法计算机检索Cochrane图书馆临床对照试验资料库(2010年第1期),PubMed(1966.1～2010.5),EMBASE(1974.1～2010.5),中国期刊全文数据库(1994.1～2010.5),中国生物医学文献数据库(1978.1～2010.5),中文科技期刊数据库(1989.1～2010.5),中华医学会数字化期刊库(1998.1～2010.5)。由2名评价者独立评价并交叉核对纳入研究的质量,对同质研究采用RevMan5.0软件进行Meta分析。结果共纳入5个随机对照试验(RCT),包括331名患者。Meta分析结果显示:延期缝合对比一期缝合处理污染的阑尾手术切口,除延期缝合有缩短住院时间的趋势外,在切口部位的感染率[OR=0.32,95%C(I0.06,1.84)],二期愈合率[OR=0.48,95%C(I0.01,16.33)]方面均无差异。结论对于污染的阑尾切口的处理,一期缝合在切口部位的感染率、二期愈合率具有与延期缝合相似的临床疗效,但限于纳入研究的局限性,尚需高质量的RCT进一步验证。Objective To evaluate the clinical efficacy of delayed primary closure versus primary closure for treating the contamination of the incision in patients with appendicitis.Methods Retrieval was performed by using the Cochrane Central Register of Controlled Trials（CENTRAL）（The Cochrane Library,Issue 1,2010）,PubMed（1966.1-2010.5）,EMBASE（1974.1-2010.5）,CNKI（1994.1-2010.5）,CBM（1978.1-2010.5）,VIP（1989.1-2010.5）,and CMD Digital Periodicals（1998.1-2010.5）.Two reviewers independently evaluated the quality of the included studies and extracted the data.Meta-analysis were performed by using RevMan 5.0 software.Results A total of 5 randomized controlled trials involving 331 patients were included.The results of meta-analysis showed that there was no significant difference in surgical site infections and secondary healing between delayed primary closure and primary closure [OR=0.32,95%CI（0.06,1.84）;OR=0.48,95%CI（0.01,16.33）].For delayed primary closure,the length of hostipal stay tended to decrease.Conclusion For treating the contamination of the incision in patients with appendicitis,delayed primary closure and primary closure have similar clinical efficacy.More high-quality randomized controlled trials should be conducted in the future.

关 键 词：延期缝合 一期缝合 阑尾切口 META分析 

分 类 号：R574.61[医药卫生—消化系统]