目的系统评价围手术期保温措施对预防手术部位感染的作用,为预防与控制手术部位感染提供循证依据。方法计算机检索Pubmed、Cochrane Library、EMBASE、中国期刊全文数据库、万方-医药期刊全文数据库、重庆维普全文数据库、中国生物医学文献数据库,并辅以手工检索、文献追溯等方法,收集围手术期采用保温措施的临床随机对照研究,筛选、评价文献质量并提取有效数据进行荟萃分析。结果筛选出符合纳入标准的随机对照试验9项,共2 916例患者,患者发生手术部位感染率保温组为4.3%,对照组为11.4%;荟萃分析结果表明,在围手术期采取适当的保温措施可以降低手术部位感染的发生率(OR=0.34,95%CI:0.25~0.47,P〈0.001)。结论围手术期采取适当的保温措施,对预防患者手术部位感染是有效的,建议围手术期采用适当的保温措施,预防轻度低体温的发生,以减少手术部位的感染。
OBJECTIVE To systematically evaluate the effect of perioperative insulation measures on prevention of surgical site infections so as to provide evidence-based basis for prevention and control of surgical site infections.METHODS The databases such as Pubmed,Cochrane Library,EMBASE,CNKI,WanFang,VIP,and CBM were retrieved in combination with manual retrieval and tracking of literature so as to conduct a randomized case-control study of the insulation measures that were adopted during the perioperative period,the quality of literature was evaluated,and the valid data were extracted for meta-analysis.RESULTS Totally 9randomized controlled trials,involving 2 916 patients,were included in the study.The incidence rate of surgical site infections was 4.3%in the insulation group,11.4%in the control group.The result of the meta-analysis indicated that the incidence of surgical site infections could be reduced after the appropriate insulation measures were taken during the perioperative period(OR=0.34,95%CI:0.25-0.47,P〈0.001).CONCLUSION The appropriate insulation measures that are taken during the perioperative period are effective in prevention of surgical site infections.It is suggested that the appropriate insulation measures should be taken to prevent the mild hypothermia during the perioperative period so as to reduce the incidence of surgical site infections.