氯己定与聚维酮碘在剖宫产中皮肤消毒效果的系统评价  

Systematic evaluation on effectiveness of chlorhexidine versus povidone iodine for skin disinfection in cesarean section

作　　者：冯缘[1] 文方[1] 赵文君[1] 黄华平[2] FENG Yuan;WEN Fang;ZHAO Wenjun;HUANG Huaping(Operating Room,Mianyang Central Hospital,Mianyang 621000,China;Nursing Department,Mianyang Central Hospital,Mianyang 621000,China)

机构地区：[1]绵阳市中心医院手术室,621000 [2]绵阳市中心医院护理部,621000

出　　处：《护理管理杂志》2020年第6期399-403,共5页Journal of Nursing Administration

摘　　要：目的评价氯己定与聚维酮碘在剖宫产中皮肤消毒的效果。方法通过系统检索PubMed,EMBASE,Cochrane Library以及中国知网(CNKI)、万方和维普数据库中与研究主题相关的中英文文献。使用Review Manager 5.3对提取到的数据进行分析并采用试验序贯分析软件对研究结果的可靠性进行评估。结果共计7篇文献涉及5826例患者纳入研究。研究结果表明,与以聚维酮碘为基础的皮肤消毒相比,以氯己定为基础的皮肤消毒能有效降低剖宫产术后的切口感染率(RR=0.75,95%CI=0.58~0.97,P=0.03);试验序贯分析显示累计样本量并未达到期望值,提示该结果还需更多研究来验证。两组患者间的皮肤不良反应以及再入院率无明显差异(P>0.05)。结论以氯己定为基础的皮肤消毒能够有效预防剖宫产术后切口感染且不增加其他不良反应,建议在临床上推广使用。Objective To evaluate the effect of chlorhexidine(CH)-based skin antisepsis versus povidone iodine(PI)-based antisepsis for the prevention of incision infection after cesarean section.Method PubMed,EMBASE,the Cochrane Library and China National Knowledge Infrastructure(CNKI)and Wanfang Data and VIP were systematically searched to identify relevant Chinese and English publications.Review Manager 5.3 was used to analyze the collected data,and trial sequential analysis(TSA)software was applied to estimate whether the overall pooled outcome was conclusive.Results Seven articles involving 5826 participants were included in the study.The outcomes showed that CH-based skin antisepsis,compared with PI-based antisepsis,was associated with a significantly decreased overall rate of surgical site infection(RR=0.75,95%CI=0.58~0.97,P=0.03).TSA revealed that the cumulative sample size did not reach the expected value,suggesting that more studies were needed to verify the finding.There was no difference in adverse skin reactions and hospital readmission between the two groups(P>0.05).Conclusion The study demonstrates that CH-based skin disinfection can effectively prevent surgical site infection after cesarean section without increasing other adverse reactions.It is recommended to promote clinical use.

关 键 词：剖宫产 氯己定 聚维酮碘 切口感染 消毒 

分 类 号：R473.71[医药卫生—护理学] R472.1[医药卫生—临床医学]