-围术期吸入高浓度氧减少外科感染的作用：一项Meta分析r.docVIP

围手术期高?浓度氧气吸?入对减少外?科感染的作?用：一项荟萃分?析 Brand?on Togio?ka, MD, Samue?l Galva?gno, DO, Shawn? Sumid?a, MD, Jamie? Murph?y, MD,Jean-Pierr?e Ouane?s, DO, and Chris?tophe?r Wu, MD Depar?tment? of Anest?hesio?logy and Criti?cal Care Medic?ine, The Johns? Hopki?ns Unive?rsity?, Balti?more, Maryl?and 摘要 背景 目前，高浓度氧气?吸入对于预?防外科手术?部位感染的?临床作用尚?不清楚，主要由于该?领域中随机?对照试验的?结论并不一?致。本系统性回?顾的目的在?于探讨围手?术期高浓度?氧气吸入能?否降低手术?刀口感染的?风险。方法 2010年?7月12日?，我们针对国?家医学图书?馆Medl?ine数据?库（见附录1）、Cochr?ane 中心CEN?TRAL数?据库、EMBAS?E数据库资?料进行了电?子检索，入选评估成?年患者围手?术期感染的?随机、对照研究，要求文献中?包含高浓度?氧气吸入组?与低浓度吸?氧组或对照?组的比较。我们主要研?究结果（外科感染）是汇总资料?比值比的9?5%可信区间，应用Coc?hrane? Colla?borat?ion’s RevMa?n 5.0.25版本软?(Cochr?ane Colla?borat?ion, Oxfor?d, UK)，并采用随机?效应模型进?行计算。结果 文献检索最?终入选包含?2728例?患者的7个?临床试验，随机分为高?氧组135?8例，对照组13?70例。高氧组总感?染率为15?.5%，对照组为1?7.5%。高氧组术野?感染率的比?值比为0.85（95%置信区间为?0.52, 1.38）（P = 0.51）。但2个亚组?（全麻和结直?肠手术亚组?）的分析结果?显示，高浓度氧气?吸入有助于?减少手术刀?口感染。结论 基于本荟萃?分析，总体来看围?手术期吸入?高浓度氧并?不能预防刀?口感染。但2个亚组?（全麻和结直?肠手术亚组?）的阳性结果?表明，高浓度氧可?降低围手术?期刀口感染?的发生率。目前，仍需进一步?的研究对高?浓度吸氧的?作用加以探?讨。 Abstr?act BACKG?ROUND? The clini?cal role of hyper?oxia for preve?nting? surgi?cal site infec?tion remai?ns uncer?tain becau?se rando?mized? contr?olled? trial?s on this topic? have repor?ted dispa?rate resul?ts. Our objec?tive in this syste?matic? revie?w was to deter?mine wheth?er perio?perat?ive hyper?oxia reduc?es surgi?cal site infec?tion. METHO?DS An elect?ronic? searc?h was condu?cted using? the Natio?nal Libra?ry of Medic?ine’s MEDLI?NE, Cochr?ane Colla?borat?ion’s CENTR?AL, and EMBAS?E datab?ases. Inclu?ded studi?es consi?sted of rando?mized? contr?olled? trial?s in an adult? popul?ation? with a clear?ly defin?ed compa?rison? of high oxyge?n versu?s low oxyge?n or contr?ol, and with a docum?ented? asses?sment? for perio?perat?ive infec?tion. Poole?d estim?ates for odds ratio?s (ORs) with 95% confi?dence? inter?vals were obtai?ned for our prima?ry outco?me (surgi?cal site infec?tion) using? the Cochr?ane Colla?borat?ion’s RevMa?n versi?on 5.0.25 (Cochr?ane Colla?bora