剖宫产术后手术部位感染的发生率：一项系统评价和Meta分析方案
Incidence of surgical site infection following caesarean section: a systematic review and meta-analysis protocol.
作者信息
Saeed Khalid B M, Greene Richard A, Corcoran Paul, O'Neill Sinéad M
机构信息
Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland.
Cork University Maternity Hospital, Cork, Ireland.
出版信息
BMJ Open. 2017 Jan 11;7(1):e013037. doi: 10.1136/bmjopen-2016-013037.
INTRODUCTION
Caesarean section (CS) rates have increased globally during the past three decades. Surgical site infection (SSI) following CS is a common cause of morbidity with reported rates of 3-15%. SSI represents a substantial burden to the health system including increased length of hospitalisation and costs of postdischarge care. The definition of SSI varies with the postoperative follow-up period among different health systems, resulting in differences in the reporting of SSI incidence. We propose to conduct the first systematic review and meta-analysis to determine the pooled estimate for the overall incidence of SSI following CS.
METHODS AND ANALYSIS
We will perform a comprehensive search to identify all potentially relevant published studies on the incidence of SSI following CS reported from 1992 in the English language. Electronic databases including PubMed, CINAHL, EMBASE and Scopus will be searched using a detailed search strategy. Following study selection, full-text paper retrieval, data extraction and synthesis, we will appraise study quality and risk of bias and assess heterogeneity. Incidence data will be combined where feasible in a meta-analysis using Stata software and fixed-effects or random-effects models as appropriate. This systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
ETHICS AND DISSEMINATION
Ethical approval is not required as this review will use published data. The review will evaluate the overall incidence of SSI following CS and will provide the first quantitative estimate of the magnitude of SSI. It will serve as a benchmark for future studies, identify research gaps and remaining challenges, and emphasise the need for appropriate prevention and control measures for SSI post-CS. A manuscript reporting the results of the systematic review and meta-analysis will be submitted to a peer-reviewed journal and presented at scientific conferences.
TRIAL REGISTRATION NUMBER
CRD42015024426.
引言
在过去三十年中，全球剖宫产率有所上升。剖宫产术后手术部位感染（SSI）是发病的常见原因，报告发生率为3%-15%。SSI给卫生系统带来了沉重负担，包括住院时间延长和出院后护理费用增加。不同卫生系统中SSI的定义因术后随访期而异，导致SSI发病率报告存在差异。我们建议进行首次系统评价和荟萃分析，以确定剖宫产术后SSI总体发病率的合并估计值。
方法与分析
我们将进行全面检索，以识别1992年以来以英文发表的所有关于剖宫产术后SSI发病率的潜在相关已发表研究。将使用详细的检索策略检索包括PubMed、CINAHL、EMBASE和Scopus在内的电子数据库。在研究选择、全文检索、数据提取和综合之后，我们将评估研究质量和偏倚风险，并评估异质性。在可行的情况下，将使用Stata软件和适当的固定效应或随机效应模型对发病率数据进行荟萃分析合并。本系统评价将根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行报告。
伦理与传播
由于本评价将使用已发表的数据，因此无需伦理批准。该评价将评估剖宫产术后SSI的总体发病率，并将首次对SSI的严重程度进行定量估计。它将作为未来研究的基准，识别研究差距和剩余挑战，并强调剖宫产术后SSI采取适当预防和控制措施的必要性。一份报告系统评价和荟萃分析结果的手稿将提交给同行评审期刊并在科学会议上发表。
试验注册号
CRD42015024426。
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