踝关节骨折术后切口感染危险因素的Meta分析

 目的 探讨踝关节骨折术后切口感染的主要危险因素。方法 计算机检索中国知网(CNKI)、万方、VIP、PubMed、Embase、Web of Science、Cochrane Library数据库自建库至2021年6月文献,由两名评价员根据纳入及排除标准独立筛选文献、提取数据和进行质量评价后,应用Rev Man 5.3和STATA 12.0软件进行Meta分析。结果 纳入12篇文献,共10 037例患者,其中切口感染560例,感染发病率为5.58%。Meta分析结果显示,踝关节骨折术后切口感染的主要危险因素包括:年龄(MD=4.70,95%CI:3.05~6.34)、身体质量指数(MD=0.82,95%CI:0.36~1.29)、术前清蛋白<35 g/L (OR=2.30,95%CI:1.26~4.22)、糖尿病(OR=1.71,95%CI:1.26~2.30)、合并心脏病(OR=2.92,95%CI:1.74~4.91)、吸烟(OR=1.51,95%CI:1.05~2.16)、饮酒(OR=1.56,95%CI:1.19~2.05)、开放性骨折(OR=5.59,95%CI:4.05~7.73)、伴有骨折脱位(OR=1.72,95%CI:1.35~2.18)、手术时间(MD=24.56,95%CI:17.59~31.53)、美国麻醉医师协会(ASA)分级≥3级(OR=2.05,95%CI:1.51~2.78)、Ⅱ~Ⅳ级污染切口(OR=4.66,95%CI:2.93~7.43)。结论 踝关节骨折术后切口感染危险因素多,医务人员应重视踝关节骨折术后切口感染的主要危险因素,采取针对性措施降低切口感染率。

Meta-analysis on risk factors for incisional infection after ankle fracture surgery

Objective To explore the main risk factors for incisional infection after ankle fracture surgery.Methods Literatures in China National Knowledge Infrastructure (CNKI), Wanfang, VIP, PubMed, Embase, Web of Science, and Cochrane Library from the establishment of the database to June 2021 were searched by computer.After two reviewers independently screened the literatures, extracted the data and evaluated the quality according to the inclusion and exclusion criteria, Meta-analysis was performed with Rev Man 5.3 and STATA 12.0 software.Results 12 literatures were included for analysis, involving10 037 patients, including 560 cases of incisional infection, incidence of incisional infection was 5.58%.Meta-analysis results showed that the main risk factors for incisional infection after ankle fracture surgery included: age (MD=4.70, 95%CI: 3.05-6.34), body mass index (MD=0.82, 95%CI: 0.36-1.29), preoperative albumin < 35 g/L (OR=2.30, 95%CI: 1.26-4.22), combined with diabetes (OR=1.71, 95%CI: 1.26-2.30), combined with heart disease (OR=2.92, 95%CI: 1.74-4.91), smoking (OR=1.51, 95%CI: 1.05-2.16), drinking (OR=1.56, 95%CI: 1.19-2.05), open fracture (OR=5.59, 95%CI: 4.05-7.73), combined with fracture dislocation (OR=1.72, 95%CI: 1.35-2.18), duration of surgery (MD=24.56, 95%CI: 17.59-31.53), American Society of Anesthesiologists (ASA) grade ≥3(OR=2.05, 95%CI: 1.51-2.78), and grade Ⅱ-Ⅳ contaminated incision (OR=4.66, 95%CI: 2.93-7.43).Conclusion There are multiple risk factors for incisional infection after ankle fracture surgery, health care workers should pay attention to the main risk factors for incisional infection after ankle fracture surgery and take targeted measures to reduce incisional infection rate.