肛瘘患者术后伤口愈合影响因素系统评价与Meta分析  

A systematic review and meta-analysis of influencing factors of postoperative wound healing in patients with anal fistul

作　　者：陈祺 刘志平 白建英 刘博[2] 冯江雪[2] CHEN Qi;LIU Zhiping;BAI Jianying;LIU Bo;FENG Jiangxu(Hebei University of Chinese Medicine,Shijiazhuang,Hebei,050011;First Department of Anorectal Surgery,Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang Hebei,050011)

机构地区：[1]河北中医药大学,河北石家庄050011 [2]河北省中医院肛肠一科,河北石家庄050011

出　　处：《中西医结合护理》2024年第12期20-30,共11页Chinese Journal of Integrative Nursing

基　　金：2022年河北省中医药管理局科研计划项目(AF/SC-08/01.0);河北省中医药康养照护研究重点实验室(SZX2021025)。

摘　　要：目的系统评价肛瘘术后患者伤口愈合的影响因素,为临床制定合理的护理措施提供理论依据。方法计算机检索中国知网(CNKI)、万方(Wanfang Data)、维普中文数据库(VIP)、PubMed、EMbase、Web of Science和The Cochrane Library英文数据库,收集影响肛瘘术后伤口愈合相关因素的临床研究。检索时限均为建库至2024年3月。两名研究者独立筛选文献、提取资料并评价纳入文献的偏倚风险后,采用RevMan5.4软件进行系统评价。结果纳入19篇文献,共2684例患者,纳入文献评价均≥6分。Meta分析结果显示:年龄≥60岁[OR=4.87,95%CI(2.41,9.82),P<0.001]、饮酒[OR=0.19,95%CI(0.11,0.28),P<0.001]、BMI<18.5 kg/m2[OR=4.99,95%CI(3.49,7.15),P<0.05]、糖尿病[OR=4.32,95%CI(2.26,8.25),P<0.001]、肛瘘病程>6个月[OR=3.23,95%CI(1.94,5.37),P<0.05]、复杂肛瘘[OR=5.38,95%CI(2.18,13.29),P<0.001]、便秘[OR=3.50,95%CI(2.46,4.98),P<0.001]、大便性状欠佳[OR=2.88,95%CI(1.80,4.33),P<0.001]、创面术后感染[OR=3.60,95%CI(2.45,5.30),P<0.001]、创面引流不畅[OR=5.69,95%CI(2.50,12.97),P<0.05]为肛瘘患者术后患者伤口愈合的的独立影响因素。结论年龄≥60岁、饮酒、糖尿病、肛瘘病程>6个月、复杂肛瘘、便秘、大便性状欠佳、创面术后感染、创面引流不畅是肛瘘患者术后伤口愈合的影响因素。可以此为参考,加强肛瘘患者围术期评估与护理,降低复发率发生率。Objective To systematically evaluate the influencing factors of wound healing in patients undergoing anal fistula surgery,and to provide a theoretical basis for the formulation of reasonable treatment and nursing measures in clinical practice.Methods The computer searched CNKI,Wanfang,VIP Chinese Database,Pubmeide,Enbas,Weber Benschens and Techco Kranali Liberi English databases to collect clinical studies related to the influencing factors of anal fistula wound healing.Studies on the effect of the influencing factors of wound healing in patients undergoing anal fistula surgery were retrieved from CNKI,Wanfang database,VIP database,PubMed,Embase,Web of Science database and The Cochrane Library from the establishment to March 2024.Two trained researchers extracted relevant information according to the inclusion and exclusion criteria,and conducted the Meta-analysis using Revman5.4 software.Results A total of 19 studies with a total of 2684 patients were included,with a score of≥6.The results of meta-analysis showed that age≥60 years old[OR=4.87,95%CI(2.41,9.82),P<0.001],alcohol consumption[OR=0.19,95%CI(0.11,0.28),P<0.001],BIM<18.5 kg/m2[OR=4.99,95%CI(3.49,7.15),P<0.05],diabetes mellitus[OR=4.32,95%CI(2.26,8.25),P<0.001],anal fistula duration>6 months[OR=5.38,95%CI(2.18,13.29),P<0.05],complex anal fistula[OR=5.38,95%CI(2.18,13.29),P<0.001],constipation[OR=3.50,95%CI(2.46,4.98),P<0.001],poor stool quality[OR=4.88,95%CI(3.09,7.69),P<0.001],wound postoperative infection[OR=3.60,95%CI(2.45,5.30),P<0.001]and poor wound drainage[OR=5.69,95%CI(2.50,12.97),P<0.05]were independent influencing factors for wound healing in patients with anal fistula after surgery.Conclusion Age(≥60 years old),alcohol consumption,diabetes,anal fistula duration>6 months,complex anal fistula,constipation,poor stool quality,postoperative wound infection,and poor wound drainage were the influencing factors of postoperative wound healing in patients with anal fistula.This can be used as a reference to strengthen the perioperative assessment

关 键 词：肛瘘 伤口愈合 影响因素 危险因素 预测因素 

分 类 号：R473.6[医药卫生—护理学]