Department of Critical Care Medicine, The Second Hospital of Shanxi Medical University, No. 382 of Wuyi Road, Xinghualing District, Taiyuan, 030001, China.
School of Nursing, Peking University, Beijing, 100191, China; Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, 100191, China.
Aust Crit Care. 2021 Jan;34(1):103-112. doi: 10.1016/j.aucc.2020.04.152. Epub 2020 Jul 6.
The objective of this study was to investigate the effects of different types of faecal collection devices on incontinence-associated dermatitis (IAD) in critically ill patients with faecal incontinence.
This was a systematic review and meta-analysis.
A comprehensive electronic literature search was performed in PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), the Cochrane library, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wanfang, and WeiPu. All the databases were searched from their inception to July 31, 2019, and the data were updated on November 2, 2019.
Randomised controlled trials (RCTs) and quasi-experimental studies were included. Participants were critically ill patients with faecal incontinence, and the interventions involved care with faecal collection devices. Comparisons were usual care, and the outcome was the incidence of IAD. Odds ratios (ORs) were used to calculate the pooled effect sizes. Heterogeneity was tested using the inconsistency index (I) method.
Nineteen studies were included in this systematic review including 16 RCTs and three quasi-experimental studies. Twelve RCTs were included in the meta-analysis, which showed that the use of faecal collection devices significantly reduced the incidence of IAD. Subgroup analyses based on device type showed significant effects for anal pouch collection devices (OR, 0.14; 95% confidence interval [CI], 0.07-0.26; P < 0.00001), anal pouch connected to negative-pressure suction devices (OR, 0.18; 95% CI, 0.08-0.42; P < 0.00001), anal catheter/tube collection devices (OR, 0.24; 95% CI, 0.13-0.44; P < 0.00001), and anal catheter/tube connected to negative-pressure suction devices (OR, 0.20; 95% CI, 0.07-0.59, P < 0.00001).
Faecal collection devices can reduce the incidence of IAD in critically ill patients with faecal incontinence. It is suggested that when using a device to care for critically ill patients with faecal incontinence, an anal pouch connected to continuous low-negative-pressure suction device should be preferred. Further high-quality research is still needed regarding anal catheter/tube collection devices and anal catheter/tube connected to continuous low-negative-pressure suction devices.
本研究旨在探讨不同类型粪便收集装置对粪便失禁危重患者失禁相关性皮炎（IAD）的影响。
这是一项系统评价和荟萃分析。
全面检索了 PubMed、Embase、护理学和联合健康文献累积索引（CINAHL）、Cochrane 图书馆、中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方和维普数据库。所有数据库均从建库起检索至 2019 年 7 月 31 日，并于 2019 年 11 月 2 日更新数据。
纳入随机对照试验（RCT）和准实验研究。研究对象为粪便失禁的危重患者，干预措施包括粪便收集装置护理。对照组为常规护理，结局为 IAD 发生率。采用比值比（OR）计算汇总效应量。采用不一致指数（I）法检验异质性。
本系统评价共纳入 19 项研究，包括 16 项 RCT 和 3 项准实验研究。12 项 RCT 纳入荟萃分析，结果显示使用粪便收集装置可显著降低 IAD 的发生率。基于装置类型的亚组分析显示，肛门袋收集装置（OR，0.14；95%置信区间 [CI]，0.07-0.26；P<0.00001）、肛门袋连接负压吸引装置（OR，0.18；95%CI，0.08-0.42；P<0.00001）、肛门导管/管收集装置（OR，0.24；95%CI，0.13-0.44；P<0.00001）和肛门导管/管连接负压吸引装置（OR，0.20；95%CI，0.07-0.59，P<0.00001）的效果显著。
粪便收集装置可降低粪便失禁危重患者 IAD 的发生率。建议在使用装置护理粪便失禁危重患者时，优先选择肛门袋连接持续低负压吸引装置。对于肛门导管/管收集装置和肛门导管/管连接持续低负压吸引装置，仍需要进一步开展高质量研究。
