Yang W, Liu Y, Zhang Y, Zhao Q-H, He S-F
Department of Anaesthesiology, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; The Teaching Centre for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
J Hosp Infect. 2016 Aug;93(4):329-38. doi: 10.1016/j.jhin.2016.03.015. Epub 2016 Mar 31.
Surgical site infection (SSI) causes significant mortality and morbidity. Administration of a high inspired oxygen fraction (FiO2) to patients undergoing surgery may represent a potential preventive strategy.
To conduct a meta-analysis of randomized controlled trials in which high FiO2 was compared with normal FiO2 in patients undergoing surgery to estimate the effect on the development of SSI.
A comprehensive search was undertaken for randomized controlled trials (until December 2015) that compared high FiO2 with normal FiO2 in adults undergoing surgery with general anaesthesia and reported on SSI.
This study included 17 randomized controlled trials with 8093 patients. Infection rates were 13.11% in the control group and 11.53% in the hyperoxic group, while the overall risk ratio was 0.893 [95% confidence interval (CI) 0.794-1.003; P = 0.057]. Subgroup analyses stratified by country, definition of SSI, and type of surgery were also performed, and showed similar results. However, high FiO2 was found to be of significant benefit in patients undergoing colorectal surgery, with a risk ratio of 0.735 (95% CI 0.573-0.944; P=0.016).
There is moderate evidence to suggest that administration of high FiO2 to patients undergoing surgery, especially colorectal surgery, reduces the risk of SSI. Further studies with better adherence to the intervention may affect the results of this meta-analysis.
手术部位感染（SSI）会导致显著的死亡率和发病率。对接受手术的患者给予高吸入氧分数（FiO2）可能是一种潜在的预防策略。
对随机对照试验进行荟萃分析，比较接受手术患者中高FiO2与正常FiO2，以评估其对SSI发生的影响。
全面检索随机对照试验（截至2015年12月），这些试验比较了全身麻醉下接受手术的成年患者中高FiO2与正常FiO2，并报告了SSI情况。
本研究纳入17项随机对照试验，共8093例患者。对照组感染率为13.11%，高氧组为11.53%，总体风险比为0.893[95%置信区间（CI）0.794 - 1.003；P = 0.057]。还按国家、SSI定义和手术类型进行了亚组分析，结果相似。然而，发现高FiO2对接受结直肠手术的患者有显著益处，风险比为0.735（95%CI 0.573 - 0.944；P = 0.016）。
有中等证据表明，对接受手术的患者，尤其是结直肠手术患者给予高FiO2可降低SSI风险。进一步严格遵循干预措施的研究可能会影响本荟萃分析的结果。
