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即时手术与传统治疗对小儿复杂性阑尾炎术后切口愈合影响的Meta 分析

Effect of instant surgery compared with traditional management on paediatric complicated acute appendicitis post-surgery wound: A meta-analysis.

机构信息

Department of Gastrointestinal Surgery, Hernia and Abdominal Wall Surgery Ⅰ, Yantai Affiliated Hospital of Binzhou Medical University, Shandong, China.

Department of Pediatrics, Yantai Affiliated Hospital of Binzhou Medical University, Shandong, China.

出版信息

Int Wound J. 2023 Oct;20(8):2964-2972. doi: 10.1111/iwj.14163. Epub 2023 Mar 25.

Abstract

A meta-analysis study to assess the influence of instant surgery (IS) compared with conservative therapy (CT) on paediatric complicated acute appendicitis (CAA) post-surgery wounds. A comprehensive literature examination until January 2023 was implemented, and 2098 linked studies were appraised. The picked studies contained 66 674 subjects with paediatric CAA post-surgery wounds in the picked studies' baseline; 64 643 of them were using IS, and 2031 were using CT. The odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to calculate the consequence of the IS compared with the CT on paediatric CAA post-surgery wounds using the dichotomous and continuous styles and a fixed or random model. The IS had a significantly higher wound infection (OR, 4.97; 95% CI, 2.35-10.54, P < .001) with moderate heterogeneity (I  = 57%) compared with the CT in a paediatric CAA post-surgery wound. However, no significant difference was found between IS and CT in total antibiotic duration (MD, -5.34; 95% CI,-12.67 to -1.98, P = .15) with high heterogeneity (I  = 95%) in paediatric CAA post-surgery wounds. The IS had a significantly higher wound infection; however, no significant difference was found in total antibiotic duration compared with the CT in paediatric CAA post-surgery wounds. Although precautions should be taken when commerce with the consequences because most of the studies picked for this meta-analysis had low sample sizes.

摘要

一项荟萃分析研究评估了即刻手术(IS)与保守治疗(CT)对小儿复杂性急性阑尾炎(CAA)术后伤口的影响。进行了全面的文献检索,截至 2023 年 1 月,评估了 2098 项相关研究。纳入的研究包含了 66674 名小儿 CAA 术后伤口患者;其中 64643 例采用 IS,2031 例采用 CT。使用二项式和连续性样式以及固定或随机模型,计算 IS 与 CT 对小儿 CAA 术后伤口的影响的优势比(OR)以及 95%置信区间(CI)。IS 与 CT 相比,小儿 CAA 术后伤口的感染风险显著更高(OR,4.97;95%CI,2.35-10.54,P <.001),存在中度异质性(I = 57%)。然而,在小儿 CAA 术后伤口中,IS 与 CT 之间的总抗生素持续时间(MD,-5.34;95%CI,-12.67 至 -1.98,P =.15)无显著差异,存在高度异质性(I = 95%)。IS 与 CT 相比,小儿 CAA 术后伤口的感染风险显著更高,但总抗生素持续时间无显著差异。尽管由于本荟萃分析纳入的大多数研究样本量较小,在解释结果时应谨慎,但应注意这一结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c415/10502279/455358787e57/IWJ-20-2964-g002.jpg

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