负压伤口疗法在肥胖产妇中应用效果的meta分析

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摘要目的探讨负压伤口疗法（NPWT）在肥胖产妇中的应用效果，为临床实践提供可靠证据。方法系统检索PubMed、EMBase、the Cochrane Central Register of Controlled Trials、ClnicalTrials.gov及中国知网、万方数据库从建库至2020年12月发表的所有符合标准的临床随机对照研究。由两名研究人员独立阅读、提取入选研究中的数据。运用Review Manager 5.3对收集的数据进行分析，TSA 0.9对研究结果的可靠性进行评估。结果共纳入9篇文献。meta分析结果显示，两组手术切口感染率比较，差异无统计学意义（RR = 0.85，95%CI：0.66~1.08，P = 0.18）；NPWT组切口感染在内的切口并发症发生率低于常规敷料组（RR = 0.81，95%CI：0.68~0.97，P = 0.02）；NPWT组除切口感染外的切口并发症发生率低于常规敷料组（RR = 0.75，95%CI：0.66~0.86，P < 0.0001）；两组再入院率比较，差异无统计学意义（RR = 1.19，95%CI：0.62~2.27，P = 0.60）。结论 NPWT能够有效降低肥胖产妇术后切口的并发症发生率，但并不能降低该类患者的切口感染率和再入院率。

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	何慧琳1 何芳1 黄华平2▲

关键词 ：剖宫产, 超重, 负压伤口疗法, meta分析

Abstract：Objective To investigate the effect of negative pressure wound therapy (NPWT) in maternal obesity, and providing the best evidence to clinical practice. Methods PubMed, EMBase, the Cochrane Central Register of Controlled Trials, ClinicalTrial.gov, CNKI, and WanFang data were systematically searched from create database to December, 2020 to identify relevant randomized controlled trials. Two authors independently read and extracted data from the selected studies. Review Manager 5.3 was applied to analyze the collected data; TSA 0.9 was used to evaluate the reliability of the study results. Results A total of nine articles were included. Meta analysis results showed that, there was no significant difference in surgical site infection rate between two groups (RR = 0.85, 95%CI: 0.66-1.08, P = 0.18); the incidence of site complications including site infection in NPWT group was lower than that in conventional dressing group (RR = 0.81, 95%CI: 0.68-0.97, P = 0.02); the incidence of site complications except site infection in NPWT group was lower than that in conventional dressing group (RR = 0.75, 95%CI: 0.66-0.86, P < 0.0001); there was no statistically significant difference in the readmission rate between two groups (RR = 1.19, 95%CI: 0.62-2.27, P = 0.60). Conclusion NPWT can effectively reduce postoperative site complication rate in maternal obesity, but it cannot reduce surgical site infection rate and readmission rate.

Key words： Cesarean section Obese Negative pressure wound therapy Meta-analysis

基金资助:四川省卫生和计划生育委员会科研课题（18PJ2 86）。

通讯作者: ▲通讯作者

引用本文:

何慧琳1 何芳1 黄华平2▲. 负压伤口疗法在肥胖产妇中应用效果的meta分析[J]. 中国医药导报, 2021, 18(36): 85-90.
HE Huilin1 HE Fang1 HUANG Huaping2▲. Meta analysis of negative pressure wound therapy in maternal obesity#br#. 中国医药导报, 2021, 18(36): 85-90.

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