腹部排水以防止尾切除术后的腹腔内,以预防复杂的尾炎
Yunhao Tang1, Jie Liu2, Guijuan Bai3
1Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
The Cochrane database of systematic reviews
|April 11, 2025
概括
针对复杂尾炎的尾切除术后的常规腹部排水没有明显的益处,可能会增加死亡风险. 关于其在预防或伤口感染等并发症方面的有效性,证据尚不确定.
科学领域:
- 外科手术 手术手术
- 胃肠病学 胃肠病学
- 基于证据的医学基于证据的医学.
背景情况:
- 尾切除术是急性尾炎的标准.
- 复杂的尾炎 (瘤性或穿孔性) 携带更高的术后并发症风险.
- 在这些情况下,常规腹部排水的作用仍然存在争议.
研究的目的:
- 评估尾切除术后腹部排水对复杂尾炎的益处和危害.
- 为了比较不同类型的手术排水和最佳的移除时间.
- 评估对腹腔内腹形成的影响.
主要方法:
- 随机对照试验 (RCT) 和准RCT的系统审查和元分析.
- 包括的研究比较了排水与没有排水,开放与封闭的排水或排水清除时间表.
- 结果包括腹腔内,伤口感染,发病率,死亡率和住院.
主要成果:
- 非常低的确定性证据表明,排水不会显著减少腹腔内或伤口感染.
- 中等确定性证据表明,排水可能会增加30天死亡风险 (Peto OR 4.88).
- 排水可能会延长住院时间,但证据非常不确定.
结论:
- 目前的证据非常不确定关于腹部排水对复杂尾炎的益处.
- 在使用排水系统时,没有显示出任何临床改善.
- 需要进行更大规模的研究来澄清对死亡率和其他结果的影响.
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