气管切口处应用泡沫敷料的Meta分析
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摘要
背景:大量研究证实,泡沫敷料能够降低气管切口处并发症的发生风险,减少换药次数,缩短愈合时间。目的:Meta分析评价泡沫敷料应用于气管切开患者的治疗效果。方法:应用计算机检索PubMed、EMBASE、Cochrane、中国学术期刊全文数据库、中国生物医学文献光盘数据库、万方数据平台和中文科技期刊数据库,有关泡沫敷料应用于气管切开患者的随机对照试验,检索时间均为建库至2018年5月。由2名研究生独立进行文献筛选、质量评价和资料提取,采用Revman5.3软件进行数据分析。结果与结论:共纳入18篇随机对照试验,观察组患者气管切口处使用泡沫敷料,对照组患者气管切口处使用无菌纱布。Meta分析结果显示:观察组气管切口处并发症发生率低于对照组[OR=0.18,95%CI(0.11,0.27),Z=7.82,P <0.000 01],气管切口处换药间隔时间长于对照组[OR=4.94,95%CI(3.70,6.18),Z=7.81,P <0.000 01],气管切口处愈合时间短于对照组[OR=-1.39,95%CI(-1.64,-1.15),Z=11.30,P <0.000 01]。结果表明,泡沫敷料应用于气管切开患者的治疗效果优于无菌纱布。
BACKGROUND: Foam dressing has been shown to reduce the risk of complications of tracheal incision, reduce the frequency of dressing change and shorten the healing time.OBJECTIVE: To evaluate the effect of foam dressing in patients undergoing tracheotomy by meta-analysis.METHODS: A computer-based search of randomized controlled trials concerning foam dressing applied in tracheotomy was carried out in PubMed, EMBASE, Cochrane, CNKI, CBM, WanFang and VIP databases before May 2018. Literature screening, quality evaluation and data extraction were conducted independently by two postgraduates. Revman 5.3 software was used for data analysis.RESULTS AND CONCLUSION: Eighteen randomized controlled trials were included. The patients in the trial group were treated with foam dressing at the trachea incision, while the control group was treated with sterile gauze at the trachea incision. Meta-analysis results showed that the incidence of tracheal incision complications in the trial group was lower than that in the control group [OR=0.18, 95%CI(0.11, 0.27), Z=7.82, P < 0.000 01], the interval of dressing change was longer than that in the control group [OR =4.94, 95%CI(3.70, 6.18), Z=7.81, P < 0.000 01], and the healing time of tracheal incision was shorter than that in the control group [OR=-1.39, 95%CI(-1.64,-1.15), Z=11.30, P < 0.000 01]. To conclude, the effect of foam dressing is better than that of sterile gauze in patients undergoing tracheotomy.
BACKGROUND: Foam dressing has been shown to reduce the risk of complications of tracheal incision, reduce the frequency of dressing change and shorten the healing time.OBJECTIVE: To evaluate the effect of foam dressing in patients undergoing tracheotomy by meta-analysis.METHODS: A computer-based search of randomized controlled trials concerning foam dressing applied in tracheotomy was carried out in PubMed, EMBASE, Cochrane, CNKI, CBM, WanFang and VIP databases before May 2018. Literature screening, quality evaluation and data extraction were conducted independently by two postgraduates. Revman 5.3 software was used for data analysis.RESULTS AND CONCLUSION: Eighteen randomized controlled trials were included. The patients in the trial group were treated with foam dressing at the trachea incision, while the control group was treated with sterile gauze at the trachea incision. Meta-analysis results showed that the incidence of tracheal incision complications in the trial group was lower than that in the control group [OR=0.18, 95%CI(0.11, 0.27), Z=7.82, P < 0.000 01], the interval of dressing change was longer than that in the control group [OR =4.94, 95%CI(3.70, 6.18), Z=7.81, P < 0.000 01], and the healing time of tracheal incision was shorter than that in the control group [OR=-1.39, 95%CI(-1.64,-1.15), Z=11.30, P < 0.000 01]. To conclude, the effect of foam dressing is better than that of sterile gauze in patients undergoing tracheotomy.
引文
[1]邵春梅,王淑敏.ICU气管切开患者肺部感染危险因素分析及护理对策[J].中华现代护理杂志,2016,22(15):2097-2100.
[2]杨欣刚,安海龙,马修尧,等.重型颅脑损伤患者气管切开术后肺部感染特点与危险因素分析[J].中华医院感染学杂志,2016,26(2):323-325.
[3]谢绍结,谢冬妮,吴红燕.胶原泡沫敷料在气管切开术患者治疗中的应用价值[J].中国药物经济学,2016,11(5):143-144.
[4]刘小玲.康惠尔敷料在气管切开患者中的应用研究[J].医学美学美容(中旬刊),2014,23(12):145-145.
[5]沈亚芳.康惠尔泡沫敷料在气管切开中的应用[J].当代护士(下旬刊),2014,7(12):189-190.
[6]杜静,王爱凤,唐景凤.康惠尔无黏胶泡沫敷料在肺部感染气管切开患者中的应用[J].实用临床医药杂志,2012,16(8):19-20.
[7]刘燕,廖燕,张雪林,等.两种处理方法对气管切开术后切口管理的效果评价[J].华西医学,2014,9(10):1930-1932.
[8]林艳香,陈秀萍.两种换药方法在气管切开患者中的应用效果[J].国际医药卫生导报,2012,18(6):855-857.
[9]赵花.美皮康泡沫敷料在气管切开换药中的应用效果观察[J].青海医药杂志,2014,44(6):34-35.
[10]胡良妃,刘熙婵.泡沫敷料用于气管切开患者伤口换药的效果观察[J].当代护士(中旬刊),2011,18(8):46-47.
[11]明静,陈花.泡沫敷料用于气管切开患者伤口换药的应用探讨[J].大家健康旬刊,2017,11(3):101.
[12]王建.泡沫敷料与纱布敷料在气管切开术后换药中的效果比较[J].东方食疗与保健,2017,18(10):54.
[13]张霞,张云,吴杨炀.泡沫敷料在颈部烧伤气管切开伤口换药中的应用[J].吉林医学,2014,35(21):4741-4742.
[14]戚金金.泡沫敷料在气管切开患者换药中的应用[J].齐鲁护理杂志,2013,19(15):122-123.
[15]郭玉妍,张朝建,侯毅.泡沫敷料在气管切开伤口换药中的应用效果观察[J].现代临床护理,2010,9(11):25-26.
[16]韩金锦.泡沫敷料在气管切开术口护理中的应用[J].医药前沿,2017,7(18):269-270.
[17]冯小艳,梁凤兰.泡沫敷料在重型颅脑损伤患者气管切开术后护理中的应用[J].医药前沿,2012,2(6):305-306.
[18]王爱凤,葛东明,王芳,等.无粘胶泡沫敷料在气管切开换药中的应用[J].中华现代护理杂志,2011,17(34):4119-4120.
[19]黄波霞.无粘胶泡沫敷料在气管切开切口换药中的应用效果[J].实用临床护理学电子杂志,2018,3(16):172.
[20]王显辉.吸收性软聚硅酮泡沫敷料在ICU重症患者气管切开切口护理中的应用效果观察[J].当代护士(上旬刊),2018,25(6):134-135.
[21]关畅.无粘胶泡沫敷料在气管切开切口换药中的应用效果观察[J].蚌埠医学院学报,2017,42(9):1277-1278.
[22]王芳,葛东明,丁涟沭.3M圆口型自粘性敷料在气管切开患者中的应用[J].中华现代护理杂志,2016,22(11):1613-1615.
[23]郑菁,陈丽丽,陈鑫鑫.湿性愈合理论在压疮护理研究进展[J].创伤与急诊电子杂志,2014,2(1):6-8.
[24]刘海平.应用薄型泡沫敷料早期干预留置针所致静脉炎的预防效果研究[J].实用临床护理学杂志,2017,2(44):173.
[25]Benskin LL.Polymeric Membrane Dressings for Topical Wound Management of Patients With Infected Wounds in a Challenging Environment:A Protocol With 3 Case Examples.Ostomy Wound Manage.2016;62(6):42-50.
[26]Manahan MN,Peters P,Scuderi S,et al.Topical timolol for a chronic ulcer-A case with its own control.Med J Aust.2014;200(1):49-50.
[27]卢蕴玉.门诊常见外科换药的护理及感染控制[J].中国继续医学教育,2016,8(31):204-206.
[28]翁秀敏.外科伤口换药时间及应注意的问题[J].中国现代药物应用,2011,5(5):220-221.
[29]贺丽,韩伟,吴江文.湿性敷料治疗在各种创面治疗中的应用进展[J].兵团医学,2017,34(4):51-55.
[30]李学川,乔亮,黄晓琴.吸水性聚氨酯泡沫敷料促进皮肤移植供皮区愈合的疗效观察[J].上海交通大学学报(医学版),2013,33(5):663-666.
[2]杨欣刚,安海龙,马修尧,等.重型颅脑损伤患者气管切开术后肺部感染特点与危险因素分析[J].中华医院感染学杂志,2016,26(2):323-325.
[3]谢绍结,谢冬妮,吴红燕.胶原泡沫敷料在气管切开术患者治疗中的应用价值[J].中国药物经济学,2016,11(5):143-144.
[4]刘小玲.康惠尔敷料在气管切开患者中的应用研究[J].医学美学美容(中旬刊),2014,23(12):145-145.
[5]沈亚芳.康惠尔泡沫敷料在气管切开中的应用[J].当代护士(下旬刊),2014,7(12):189-190.
[6]杜静,王爱凤,唐景凤.康惠尔无黏胶泡沫敷料在肺部感染气管切开患者中的应用[J].实用临床医药杂志,2012,16(8):19-20.
[7]刘燕,廖燕,张雪林,等.两种处理方法对气管切开术后切口管理的效果评价[J].华西医学,2014,9(10):1930-1932.
[8]林艳香,陈秀萍.两种换药方法在气管切开患者中的应用效果[J].国际医药卫生导报,2012,18(6):855-857.
[9]赵花.美皮康泡沫敷料在气管切开换药中的应用效果观察[J].青海医药杂志,2014,44(6):34-35.
[10]胡良妃,刘熙婵.泡沫敷料用于气管切开患者伤口换药的效果观察[J].当代护士(中旬刊),2011,18(8):46-47.
[11]明静,陈花.泡沫敷料用于气管切开患者伤口换药的应用探讨[J].大家健康旬刊,2017,11(3):101.
[12]王建.泡沫敷料与纱布敷料在气管切开术后换药中的效果比较[J].东方食疗与保健,2017,18(10):54.
[13]张霞,张云,吴杨炀.泡沫敷料在颈部烧伤气管切开伤口换药中的应用[J].吉林医学,2014,35(21):4741-4742.
[14]戚金金.泡沫敷料在气管切开患者换药中的应用[J].齐鲁护理杂志,2013,19(15):122-123.
[15]郭玉妍,张朝建,侯毅.泡沫敷料在气管切开伤口换药中的应用效果观察[J].现代临床护理,2010,9(11):25-26.
[16]韩金锦.泡沫敷料在气管切开术口护理中的应用[J].医药前沿,2017,7(18):269-270.
[17]冯小艳,梁凤兰.泡沫敷料在重型颅脑损伤患者气管切开术后护理中的应用[J].医药前沿,2012,2(6):305-306.
[18]王爱凤,葛东明,王芳,等.无粘胶泡沫敷料在气管切开换药中的应用[J].中华现代护理杂志,2011,17(34):4119-4120.
[19]黄波霞.无粘胶泡沫敷料在气管切开切口换药中的应用效果[J].实用临床护理学电子杂志,2018,3(16):172.
[20]王显辉.吸收性软聚硅酮泡沫敷料在ICU重症患者气管切开切口护理中的应用效果观察[J].当代护士(上旬刊),2018,25(6):134-135.
[21]关畅.无粘胶泡沫敷料在气管切开切口换药中的应用效果观察[J].蚌埠医学院学报,2017,42(9):1277-1278.
[22]王芳,葛东明,丁涟沭.3M圆口型自粘性敷料在气管切开患者中的应用[J].中华现代护理杂志,2016,22(11):1613-1615.
[23]郑菁,陈丽丽,陈鑫鑫.湿性愈合理论在压疮护理研究进展[J].创伤与急诊电子杂志,2014,2(1):6-8.
[24]刘海平.应用薄型泡沫敷料早期干预留置针所致静脉炎的预防效果研究[J].实用临床护理学杂志,2017,2(44):173.
[25]Benskin LL.Polymeric Membrane Dressings for Topical Wound Management of Patients With Infected Wounds in a Challenging Environment:A Protocol With 3 Case Examples.Ostomy Wound Manage.2016;62(6):42-50.
[26]Manahan MN,Peters P,Scuderi S,et al.Topical timolol for a chronic ulcer-A case with its own control.Med J Aust.2014;200(1):49-50.
[27]卢蕴玉.门诊常见外科换药的护理及感染控制[J].中国继续医学教育,2016,8(31):204-206.
[28]翁秀敏.外科伤口换药时间及应注意的问题[J].中国现代药物应用,2011,5(5):220-221.
[29]贺丽,韩伟,吴江文.湿性敷料治疗在各种创面治疗中的应用进展[J].兵团医学,2017,34(4):51-55.
[30]李学川,乔亮,黄晓琴.吸水性聚氨酯泡沫敷料促进皮肤移植供皮区愈合的疗效观察[J].上海交通大学学报(医学版),2013,33(5):663-666.