开心手术后胸部伤口感染的危险因素:系统性审查和元分析
Dongsheng Chen1, Jianghe Zhang2, Yuting Wang1
1Department of Plastic and Reconstructive Surgery, The First Medical Centre of Chinese PLA General Hospital, Beijing, China.
International wound journal
|November 1, 2023
概括
这项研究确定了开心手术后胸部伤口感染的关键风险因素. 糖尿病,肥胖和长期手术是显著的预测因素,突出显示了这种并发症的多因素性质.
科学领域:
- 心血管外科心血管外科
- 传染病流行病学 传染病流行病学
背景情况:
- 部伤口感染 (SWI) 是开心手术后的一种严重并发症.
- 确定独立的风险因素对于有效的预防策略至关重要.
研究的目的:
- 使用元分析量化和系统地确定SWI的独立风险因素.
- 评估各种潜在风险因素的稳定性和强度.
主要方法:
- 系统的文献搜索和数据提取.
- 使用随机效应模型对33个显著变量的元分析.
- 评估异质性,出版偏见和敏感性分析.
主要成果:
- 强大的独立风险因素包括糖尿病,肥胖,双边内胸动脉的使用,慢性肺炎,长时间的手术/通风和临界手术前状态.
- 充血性心力衰竭,心房动,功能衰竭,中风,周围血管疾病和大动脉内气球的使用也很重要.
- 65岁以上的年龄,NYHA类>2,以及手术前停留并不是显著的风险因素.
结论:
- SWI是多因素的,鉴定的风险因素的强度各不相同.
- 影响伤口愈合的因素 (如免疫力受损,营养不良) 会增加SWI的风险.
- 为了减轻SWI风险,全面的经营管理是必不可少的.
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