Wang Xiaorui, Li Xia, Zhang Jiying
Department of Anesthesia, Beijing Electric Power Hospital, Beijing, China.
Int Wound J. 2023 Sep 24;21(2). doi: 10.1111/iwj.14391.
In this study, a meta-analysis was conducted to assess the effect of refined nursing interventions in the operating room on the incidence of surgical-site wound infections in patients undergoing lung cancer surgery to provide an evidence base for the prevention and management of nosocomial infections. A computerised literature search was used to identify randomised controlled trials (RCTs) on the application of refined nursing interventions in the operating room in patients undergoing lung cancer surgery published in the PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP and Wanfang databases from their inception until July 2023. The literature screening, data extraction and quality assessment of the included studies were performed independently by two researchers. RevMan 5.4 software was used for the meta-analysis. Twenty-eight studies were included in the analysis, with a total of 2406 patients, including 1210 patients in the refined nursing intervention group and 1196 patients in the control group. The results of the meta-analysis showed that the refined nursing interventions in the operating room significantly reduced the incidence of surgical-site wound infections in patients undergoing lung cancer surgery, compared with the control group (1.82% vs. 6.52%, odds ratio: 0.30, 95% CI: 0.19-0.47, p < 0.001), and shortened the length of hospital stay (standardised mean difference: -1.51 days, 95% CI: -1.92 to -1.11 days, p < 0.001). Current evidence suggests that the application of refined nursing interventions in the operating room is effective at reducing the incidence of surgical-site wound infections and shortening the length of hospital stay in patients undergoing lung cancer surgery. However, owing to the small number and low quality of the studies, more high-quality RCTs with large sample sizes are needed to confirm these results.
在本研究中,进行了一项荟萃分析,以评估手术室精细化护理干预对肺癌手术患者手术部位伤口感染发生率的影响,为医院感染的预防和管理提供证据基础。通过计算机文献检索,识别在PubMed、EMBASE、Cochrane图书馆、中国知网(CNKI)、维普(VIP)和万方数据库中发表的、从创刊至2023年7月关于手术室精细化护理干预在肺癌手术患者中的应用的随机对照试验(RCT)。纳入研究的文献筛选、数据提取和质量评估由两名研究人员独立进行。使用RevMan 5.4软件进行荟萃分析。分析纳入了28项研究,共2406例患者,其中精细化护理干预组1210例,对照组1196例。荟萃分析结果显示,与对照组相比,手术室精细化护理干预显著降低了肺癌手术患者手术部位伤口感染的发生率(1.82%对6.52%,比值比:0.30,95%置信区间:0.19 - 0.47,p < 0.001),并缩短了住院时间(标准化均差:-1.51天,95%置信区间:-1.92至-1.11天,p < 0.001)。目前的证据表明,在手术室应用精细化护理干预可有效降低肺癌手术患者手术部位伤口感染的发生率并缩短住院时间。然而,由于研究数量少且质量低,需要更多大样本的高质量RCT来证实这些结果。