Han Jing, Liu Xin-Ju
Department of Spinal Joint Surgery, Jinan City People's Hospital, Jinan, China.
Department of Oncology, Jinan City People's Hospital, Jinan, China.
Int Wound J. 2023 Oct 27;21(2). doi: 10.1111/iwj.14469.
This study aimed to systematically evaluate the effects of clinical nursing on surgical site wound infections and postoperative complications in patients after undergoing total knee arthroplasty (TKA). Computerised searches of Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, VIP and Wanfang databases were conducted from inception to August 2023 to collect randomised controlled trials (RCTs) on patients with TKA who received clinical nursing pathway interventions. Literature screening, data extraction and quality assessment of the included studies were performed independently by two researchers. The meta-analysis was performed using Stata 17.0. A total of 14 RCTs with 1174 patients were included, including 587 patients each in the intervention and control groups. The meta-analysis results showed that the application of clinical nursing pathways to patients undergoing TKA significantly reduced surgical site wound infections (risk ratio [RR] = 0.28, 95% confidence interval [CI]: 0.15-0.54, p < 0.001) and postoperative complications (RR = 0.25, 95% CI: 0.17-0.37, p < 0.001). Therefore, clinical nursing pathway interventions in patients undergoing TKA should be promoted in clinical practice as they can effectively reduce the incidence of wound infection and postoperative complications.
本研究旨在系统评价临床护理对全膝关节置换术（TKA）患者手术部位伤口感染及术后并发症的影响。从数据库建库至2023年8月，对Embase、PubMed、Cochrane图书馆、中国知网、维普和万方数据库进行计算机检索，以收集接受临床护理路径干预的TKA患者的随机对照试验（RCT）。由两名研究人员独立进行纳入研究的文献筛选、数据提取和质量评估。使用Stata 17.0进行荟萃分析。共纳入14项RCT，涉及1174例患者，干预组和对照组各587例。荟萃分析结果显示，对TKA患者应用临床护理路径可显著降低手术部位伤口感染（风险比[RR]=0.28，95%置信区间[CI]：0.15 - 0.54，p<0.001）和术后并发症（RR=0.25，95%CI：0.17 - 0.37，p<0.001）。因此，TKA患者的临床护理路径干预在临床实践中应予以推广，因为它们可以有效降低伤口感染和术后并发症的发生率。
