Liang Mining, Chen Qiongni, Zhang Yang, He Li, Wang Jianjian, Cai Yiwen, Li Lezhi
Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
Department of Nursing, The Second Xiangya Hospital, Central South University, Hunan Province, Changsha, China.
Oncotarget. 2017 Feb 28;8(9):14516-14524. doi: 10.18632/oncotarget.14312.
Diabetes is a major cause of morbidity for patients undergoing surgery and can increase the incidence of some postoperative complications such as bedsores. We conducted a meta-analysis of observational studies to examine whether patients with diabetes undergoing surgery had high risk of bedsore. We performed a systematic literature search in Pubmed, Embase and the Cochrane Library Central Register of Controlled Trials database from inception to November 2016. Studies were selected if they reported estimates of the relative risk (RR) for bedsore risk in postoperative diabetic patients compared with that of in non-diabetic patients. Random-effects meta-analysis was conducted to pool the estimates. A total of 16 studies with 24,112 individuals were included in our meta-analysis. The pooled RR of bedsore development for patients with diatetes was 1.77 (95% CI 1.45 to 2.16). The results of subgroup analyses were consistent when stratified by surgery type, study design, research region, sample size, inclusion period, analysis method and study quality. There was evidence of publication bias among studies and a sensitivity analysis using the Duval and Tweedie "trim-and-fill" method did not significantly alter the pooled results (adjusted RR 1.17, 95% CI 1.02 to 1.36).This meta-analysis provides indications that diabetic patients undergoing surgery could have a higher risk of developing bedsores. Further large-scale prospective trials should be implemented to comfirm the association.
糖尿病是手术患者发病的主要原因，并且会增加一些术后并发症的发生率，如褥疮。我们进行了一项观察性研究的荟萃分析，以检验接受手术的糖尿病患者发生褥疮的风险是否较高。我们在PubMed、Embase和Cochrane图书馆临床试验中央注册库数据库中进行了系统的文献检索，检索时间从建库至2016年11月。如果研究报告了术后糖尿病患者与非糖尿病患者相比褥疮风险的相对风险（RR）估计值，则将其纳入。采用随机效应荟萃分析来汇总估计值。我们的荟萃分析共纳入了16项研究，涉及24112名个体。糖尿病患者发生褥疮的合并RR为1.77（95%CI为1.45至2.16）。按手术类型、研究设计、研究地区、样本量、纳入期、分析方法和研究质量进行分层时，亚组分析结果一致。研究中存在发表偏倚的证据，使用Duval和Tweedie“修剪和填充”方法进行的敏感性分析并未显著改变汇总结果（调整后的RR为1.17，95%CI为1.02至1.36）。这项荟萃分析表明，接受手术的糖尿病患者发生褥疮的风险可能更高。应开展进一步的大规模前瞻性试验来证实这种关联。
