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在脏移植手术中预防性围排水放置:系统性审查和元分析
Adil S Lakha1,2, Shahzaib Ahmed3, James Hunter2,4
1Oxford University Hospitals National Health Service (NHS) Foundation Trust, Oxford, United Kingdom.
概括
在移植中,预防性围排水不会显著降低再干预率或围采集. 证据不支持常规排水用于改善结果或移植存活.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 外科手术的结果
- 移植医学 移植医学
背景情况:
- 脏移植在全球范围内是一种常见的手术.
- 预防性围排水的使用是不一致的.
- 目前的证据缺乏关于常规排水布置的好处与风险的共识.
研究的目的:
- 评估预防性围疏通是否减少了对移植受体的术后再干预的需要.
- 评估预防性排水对周收藏,伤口并发症和移植存活的影响.
主要方法:
- 一个系统的审查和元分析,遵循PRISMA指南.
- 在2023年6月搜索了四个数据库,确定了1540个独特的文章.
- 包括四项对元分析的回顾性队列研究,以95%的置信区间和几率比率呈现结果.
主要成果:
- 对三项研究的元分析发现,再干预率没有显著降低 (OR = 0.59;95% CI:0.16-2.23;p = 0.44).
- 预防性排水时没有观察到周围收集的显著减少 (OR = 0.55;95% CI:0.13-2.37;p = 0.42).
- 没有强有力的证据表明减少了表面伤口并发症或改善了12个月的移植存活率.
结论:
- 目前的证据不支持在移植中常规使用预防性围排水.
- 需要进一步进行高质量的前性研究,以最终评估风险和益处.
- 这些发现表明,需要重新考虑当前在这种患者群体中排水放置的做法.
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