骨折患者切开内固定术围术期使用不同疗程抗菌药物预防感染的Meta分析

发布时间：2018-07-25 17:12

【摘要】：目的:系统评价骨折患者切开内固定术围术期应用单剂量与多剂量抗菌药物预防手术部位感染的疗效,为临床提供循证参考。方法:计算机检索PubMed、EMBase、Corchrane图书馆、中国生物医学文献数据库、相关期刊论文、中文科技期刊数据库和万方数据库,查找闭合性骨折患者行切开内固定术治疗后,围术期应用单剂量(试验组)与多剂量(对照组)抗菌药物预防手术部位感染的随机对照试验(RCT),筛选文献、提取资料并按照改良的Jadad评分量表评价质量后,采用Rev Man 5.3统计软件进行Meta分析。结果:最终纳入8项RCT,合计3457例患者。Meta分析结果显示,两组患者手术部位感染率比较,差异无统计学意义[OR=1.02,95%CI(0.63,1.66),P=0.94]。依据用药不同选择使用头孢唑啉的研究进行亚组分析,Meta分析结果显示,手术部位感染率比较,差异仍无统计学意义[OR=1.33,95%CI(0.55,3.20),P=0.52]。结论:闭合性骨折行切开内固定术治疗患者,围术期推荐单剂量预防性应用抗菌药物。
[Abstract]:Objective: to evaluate the efficacy of single dose and multi-dose antibiotics in preventing site infection in patients with fracture during perioperative period of open and internal fixation, and to provide evidence-based reference for clinical practice. Methods: a computer-based search was conducted for PubMeden EMBaseen Corchrane Library, Chinese Biomedical Literature Database, Chinese Journal Full-text Database, Chinese Science and Technology Journal Database and Wanfang Database to find out the patients with closed fracture treated by open and internal fixation. In the perioperative period, single dose (trial group) and multiple dose (control group) antibiotics were used to prevent infection in surgical site. The literature was screened by randomized controlled trial (RCT),). The data were extracted and the quality was evaluated according to the modified Jadad scale. Meta analysis was carried out with Rev Man 5.3 statistical software. Results: eight RCTs were included. The results of Meta-analysis of 3457 patients showed that there was no significant difference in the infection rate between the two groups [OR1. 02 ~ 95 CI (0. 63 / 1. 66) P 0. 94]. According to the different choice of cefazolin, the subgroup analysis and Meta-analysis showed that there was no significant difference in the infection rate of surgical site [ORX 1.33 / 95 CI (0.553.20) P 0.52]. Conclusion: patients with closed fracture were treated with open internal fixation and single dose of prophylactic antimicrobial agents was recommended during perioperative period.
【作者单位】：宝鸡市中心医院临床药学室;
【基金】：陕西省卫生厅卫生科研基金项目(No.2010H42)
【分类号】：R687.3

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