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洗必泰（氯己定）能否降低拔牙术后菌血症的发生率？系统评价和荟萃分析。

Does chlorhexidine reduce bacteremia following tooth extraction? A systematic review and meta-analysis.

机构信息

Department of Stomatology I, University of the Basque Country (UPV/EHU) Bizkaia, Spain.

BioCruces Health Research Institute, Bizkaia, Spain.

出版信息

PLoS One. 2018 Apr 23;13(4):e0195592. doi: 10.1371/journal.pone.0195592. eCollection 2018.

DOI:10.1371/journal.pone.0195592
PMID:29684028
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5912716/
Abstract

BACKGROUND AND AIMS

Scientific evidence is not clear regarding the use of antimicrobial mouth rinse before dental extraction to reduce bacteremia. We tested the null hypothesis that there would be no difference in the incidence of bacteremia following dental extractions in patients treated with or without chlorhexidine.

MATERIAL AND METHODS

We conducted a meta-analysis following the recommendations proposed by PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The data sources Pubmed, Cochrane, Web of Science, Science Direct, Scopus, and Ovid MD were searched until April 30, 2017. (chlorhexidine) AND (bacteremia OR bacteraemia) AND (extraction OR removal) were used as key words in a free-text search. Published meeting abstracts were searched. The references of each article were reviewed. We only included randomized controlled clinical trials. There were no restrictions regarding language or date of publication. The outcome measure was the incidence of the bacteremia measured within the first ten minutes post-extraction. Two reviewers independently undertook the risk of bias assessment and data extraction. A fixed-effects inverse variance weighted meta-analysis was conducted.

RESULTS

Out of 18 studies, eight eligible trials with 523 participants were selected, 267 in the experimental group and 256 in the control group: risk ratio = 0.882 (95% confidence interval 0.799 to 0.975; p = 0.014), heterogeneity I2 = 13.07%, and p = 0.33. The number needed to treat was 16 (95% CI 7-Infinity).

CONCLUSIONS

Approximately 12% of bacteremia cases can be prevented if a population is exposed to chlorhexidine. CRD42016046586.

摘要

背景与目的

关于在拔牙前使用抗菌漱口水以减少菌血症的证据尚不明确。我们检验了一个零假设，即在接受或不接受洗必泰治疗的患者中，拔牙后菌血症的发生率没有差异。

材料和方法

我们根据 PRISMA（系统评价和荟萃分析的首选报告项目）建议进行了荟萃分析。检索了 Pubmed、Cochrane、Web of Science、Science Direct、Scopus 和 Ovid MD 等数据来源，检索时间截至 2017 年 4 月 30 日。（洗必泰）和（菌血症或菌血症）和（提取或去除）作为自由文本搜索的关键字。检索了已发表的会议摘要。回顾了每篇文章的参考文献。我们仅纳入随机对照临床试验。语言或发表日期没有限制。结局指标为拔牙后 10 分钟内测量的菌血症发生率。两位评审员独立进行了偏倚风险评估和数据提取。采用固定效应逆方差加权荟萃分析。

结果

在 18 项研究中，有 8 项符合条件的试验共 523 名参与者入选，实验组 267 名，对照组 256 名：风险比=0.882（95%置信区间 0.799 至 0.975；p=0.014），异质性 I2=13.07%，p=0.33。需要治疗的人数为 16 人（95%可信区间 7-无穷大）。

结论

如果人群接触洗必泰，大约 12%的菌血症病例可以预防。CRD42016046586。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e38/5912716/2751f41a3fed/pone.0195592.g007.jpg
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