胫骨开放骨折内固定后抗生素预防深层感染的Meta分析  

Systematic review and meta-analysis of effect of antibiotic therapy for prevention of deep infection in open tibia fractures treated with internal fixation

作　　者：张武 周华朝 李燕 周建国[2] 

机构地区：[1]枣庄矿业集团枣庄医院,山东枣庄277101 [2]南京市浦口区中医院

出　　处：《中国骨与关节损伤杂志》2015年第12期1273-1275,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的 运用Meta分析软件,探讨胫骨开放性骨折内固定后应用抗生素预防深层感染的疗效。方法 通过MEDLINE、PUBMED、EMBASE、WOS检索2000-2015年相关文献,采用Jadad评分评估所涉及研究的质量,取得胫骨开放性骨折内固定后使用抗生素患肢深层感染发生的RR、95%可信期间,统计分析所有研究的胫骨开放骨折预防使用抗生素深层感染发生风险。结果 16项研究共计12 506例入选,Meta分析结果显示：胫骨开放骨折髓内钉固定术后使用抗生素预防深层感染总风险差异有统计学意义[RR=0.071,95%CI（0.059,0.085）,P=0.000];静脉使用抗生素后感染发生风险差异有统计学意义[RR=0.129,95%CI（0.100,0.167）,P=0.000];患处局部使用抗生素感染发生风险差异无统计学意义[RR=0.017,95%CI（0.005,0.055）,P=0.378];植入物表面使用抗生素感染发风险差异有统计学意义[RR=0.039,95%CI（0.029,0.051）,P=0.000]。结论 胫骨开放骨折患者内固定术后预防使用抗生素能明显降低患处感染发生率。Objective To evaluate effect of antibiotic therapy for prevention of deep infection in open tibia fractures treated with internal fixation. Methods Related articles（2000-2015） were searched in MEDLINE, PUBMED, EMBASE, WOS. The qualities of the included studies were evaluated by the Jadad scale. RR and 95% CI were evaluated by meta-analysis. Results A total of 16 studies were adopted and the number of cases was 12 506. The meta-analysis showed that： the total effect of antibiotic therapy for prevention of infection in open tibia fractures treated with internal fixation [ RR =0.071,95% CI（0.059,0.085）,P =0.000], the difference was significant; the effect of vein antibiotic therapy for infection [ RR =0.129,95%CI（0.100,0.167）,P =0.000], the difference was significant;the effect of local antibiotic therapy for prevention of infection [RR =0.017,95% CI（0.005,0.055）,P =0.378], the difference was not significant;Deep wound infections in long-bone fractures treated with antibiotics delivered at the tissue-implant interface[RR =0.039,95%CI（0.029,0.051）,P =0.000], the difference was significant. Conclusion The antibiotics used by prophylaxis can significantly decrease local infection rate for open tibia fractures treated with internal fixation.

关 键 词：胫骨骨折 局部抗生素 感染 META分析 相对危险度 

分 类 号：R687.3[医药卫生—骨科学]