胫骨骨折切开复位内固定术后感染危险因素的Meta分析  

Risk factors of infection of tibia fractures after open reduction and internal fixation:a meta-analysis

作　　者：汤一帆 顾则娟 邢双双[1] 周元 TANG Yi-fan;GU Ze-juan;XING Shuang-shuang;ZHOU Yuan(College of Nursing, Nanjing Medical University, Nanjing, Jiangsu 210029, China)

机构地区：[1]南京医科大学护理学院,江苏南京210029 [2]南京医科大学第一附属医院

出　　处：《中国骨与关节损伤杂志》2018年第5期488-491,共4页Chinese Journal of Bone and Joint Injury

基　　金：江苏省医学创新团队(苏卫科教[2017]1号);江苏省高校重点专业建设项目(JX222201231)

摘　　要：目的通过Meta分析总结胫骨骨折切开复位内固定术后感染的危险因素,为临床治疗胫骨骨折和预防术后感染提供循证医学依据。方法检索Pub Med、EMBASE、Web of Science、Cochrane、中国知网、万方、维普等数据库2017-04以前发表的关于胫骨骨折切开复位内固定术后感染危险因素的相关文献。2位研究者独立提取被纳入文献的相关数据,采用Revman 5.3.5软件进行Meta分析。结果纳入8篇文献,共1 925例胫骨骨折,其中243例术后感染,感染率平均12.6%(7.6%~23.6%)。Meta分析结果显示,男性、吸烟、肥胖(BMI>30 kg/m^2)、糖尿病、开放性骨折、骨筋膜室综合征、外固定、双钢板、双切口、受伤至手术时间是胫骨骨折切开复位内固定术后感染的危险因素,差异有统计学意义(P<0.05)。年龄、种族不是胫骨骨折切开复位内固定术后感染的危险因素,差异无统计学意义(P>0.05)。结论男性、吸烟、肥胖、糖尿病、开放性骨折、骨筋膜室综合征、外固定、双钢板、双切口、受伤至手术时间是胫骨骨折切开复位内固定术后感染的危险因素,临床医护人员应更加关注以上相关危险因素以避免胫骨骨折术后发生感染。Objective To summarize risk factors associated with the infection of tibia fractures after open reduction and internal fixation（ORIF） and to provide evidence for prevention decisions through meta-analysis. Methods The computerized and additional manual searches were performed in Pub Med, Embase, Web of Science, Cochrane central database, CNKI,Wanfang data, et al for potential studies published before April 2017. Two reviewers independently extracted the relevant data from the included studies. Data was analyzed by meta-analysis using software Revman 5.3.5. Results Eight studies including1 925 cases of tibia fractures and 243 infections, with 12.6% of averaged infection rate（7.6%-23.6%）, were eligible and included in this meta-analysis. Our meta-analysis identified the following significant increased risk factors for infection： male,smoking, BMI30 kg/m^2, diabetes, open fracture, compartment syndrome, external fixation, two plates, two incisions, time from injury to definitive surgical procedure（P〈 0.05）. Age and race were not risk factors for the infection of tibia fractures after ORIF（P〉 0.05）. Conclusion Male, Smoking, BMI 30 kg/m^2, diabetes, open fracture, compartment syndrome, external fixation, two plates, two incisions, time from injury to definitive surgical procedure（days） are significant risk factors associated with the infection of tibia fractures after ORIF. Patients involved with the above-mentioned medical conditions should be carefully paid close attention by clinical staff of the orthopedic to reduce the infection of tibia fractures after ORIF.

关 键 词：胫骨骨折 切开复位内固定 感染 危险因素 META分析 

分 类 号：R687.3[医药卫生—骨科学]