| 杨索,谌永毅,刘华云,朱小妹,刘阳,龚有文.术前造口定位对肠造口患者并发症发生率影响的meta分析[J].上海护理,2024,24(1): |
| 术前造口定位对肠造口患者并发症发生率影响的meta分析 |
| The effect of preoperative stoma site marking on the incidence of stoma-related complications in patients with enterostomy: a meta-analysis |
| DOI： |
| 中文关键词: 术前造口定位 肠造口 造口相关并发症 Meta分析 |
| 英文关键词:preoperative stoma site marking enterostomy stoma-related complications Meta-analysis |
| 基金项目:湖南省中医肿瘤护理研究生培养创新实践基地开放基金项目 |
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| 中文摘要: |
| 目的：评价术前造口定位对肠造口患者造口相关并发症发生率影响，为临床实践提供循证依据。 方法：检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、Pubmed、Cochrane Library、CINAHL、Embase、Ovid Emcare、British Nursing Index，检索时限为建库至2022年6月15日。由2名研究者独立进行文献筛选、资料提取和质量评价后，采用RevMan 5.3软件进行统计分析。结果：共纳入32篇文献，Meta分析结果显示，术前造口定位可有效降低造口相关并发症总发生率[RR=0.38,95%CI(0.28,0.53),P<0.00001]、造口周围皮肤并发症发生率[RR=0.47,95%CI(0.29,0.75),P=0.002]、造口渗漏发生率[RR=0.20,95%CI(0.09,0.45),P<0.0001]、皮肤黏膜分离发生率[RR=0.28,95%CI(0.13,0.61),P=0.002]、造口回缩发生率[RR=0.50,95%CI(0.27,0.92),P=0.03]、造口狭窄发生率[RR=0.27,95%CI(0.10,0.72),P=0.009]、造口旁疝发生率[RR=0.23,95%CI(0.14,0.36),P<0.00001]、造口脱垂发生率[RR=0.38,95%CI(0.19,0.76),P=0.006]、造口出血发生率[RR=0.26,95%CI(0.08,0.78),P=0.02]，但不能显著降低造口缺血发生率[RR=0.45,95%CI(0.15,1.38),P=0.16]及造口水肿发生率[RR=0.23,95%CI(0.00,28.52),P=0.55]。 结论：术前造口定位能有效降低肠造口患者造口相关并发症总发生率以及造口周围皮肤并发症、造口渗漏、皮肤黏膜分离、造口回缩、造口狭窄、造口旁疝、造口脱垂、造口出血发生率，但对于降低造口缺血及造口水肿发生率的证据不足。 |
| 英文摘要: |
| Objective: To evaluate the effect of preoperative stoma site marking on the incidence of stoma-related complications in patients with enterostomy, and to provide evidence for clinical practice. Methods: We searched CNKI, Wanfang Data , VIP , CBM, Pubmed, Cochrane Library, CINAHL, Embase, Ovid Emcare and British Nursing Index from the inception to June 15, 2022. After literature screening, data extraction and quality evaluation by two researchers independently, RevMan 5.3 was used for statistical analysis. Results: A total of 32 articles were included. The results of meta-analysis showed that preoperative stoma site marking can effectively reduce the overall incidence of stoma-related complications [RR=0.38, 95%CI(0.28, 0.53), P <0.00001], the incidence of peristomal skin complications [RR=0.47, 95%CI(0.29, 0.75), P=0.002], and the incidence of leakage[RR=0.20, 95%CI(0.09,0.45), P<0.0001], the incidence of mucocutaneous separation[RR=0.28, 95%CI(0.13,0.61), P=0.002], the incidence of stoma retraction[RR=0.50, 95%CI(0.27,0.92), P=0.03], the incidence of stoma stenosis[RR=0.27, 95%CI(0.10,0.72), P=0.009], the incidence of parastomal hernia [RR=0.23, 95%CI(0.14,0.36), P<0.00001], the incidence of stoma prolapse [RR=0.38, 95%CI(0.19,0.76), P=0.006] and the incidence of bleeding [RR=0.26, 95%CI(0.08,0.78), P=0.02], But not significantly reduced the incidence of ischemia [RR=0.45, 95%CI(0.15,1.38), P=0.16] and the incidence of edema [RR=0.23, 95%CI(0.00,28.52), P=0.55]. Conclusion: Preoperative stoma site marking can effectively reduce the overall incidence of stoma-related complications and the incidence of peristomal skin complications, leakage, mucocutaneous separation, stoma retraction, stoma stenosis, parastomal hernia, stoma prolapse and bleeding. However, there is insufficient evidence to reduce the incidence of stoma ischemia and stoma edema. |
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