Department of Emergency, People's Hospital Affiliated to Shandong First Medical University, Jinan, China.
Department of Obstetrics, People's Hospital Affiliated to Shandong First Medical University, Jinan, China.
Int Wound J. 2024 Apr;21(4):e14600. doi: 10.1111/iwj.14600. Epub 2023 Dec 25.
This study aimed to explore the impact of clinical nursing pathway applied to acute appendicitis surgery on patients' postoperative wound infections and complications. A computerised search of PubMed, Cochrane Library, Web of Science, EMBASE, Wanfang, Chinese Biomedical Literature Database and China National Knowledge Infrastructure was conducted and supplemented by a manual search, from database inception to October 2023, to collect randomised controlled trials (RCTs) on the application of clinical nursing pathways to acute appendicitis surgery. Literature screening, data extraction and quality assessment of the included literature were carried out independently by two researchers. RevMan 5.4 software was applied for data analysis. Twenty-one RCTs with a total of 2408 patients were finally included. The analysis revealed the implementation of clinical nursing pathway could effectively reduce the incidence of wound infection (OR = 0.26, 95% CI: 0.15-0.46, p < 0.001) and postoperative complications (OR = 0.20, 95% CI: 0.15-0.27, p < 0.001), as well as shorten the hospital length of stay (MD = -3.26, 95% CI: -3.74 to -2.79, p < 0.001) and accelerated the time to first ventilations (MD = -14.85, 95% CI: -21.56 to -8.13, p < 0.001), as well as significantly improved patient satisfaction (OR = 5.52, 95% CI: 3.52-8.65, p < 0.001) in patients undergoing surgery for acute appendicitis. The application of clinical nursing pathway in acute appendicitis surgery can significantly reduce postoperative wound infection and complications, and at the same time can shorten the hospital length of stay as well as improve the satisfaction of patients.
本研究旨在探讨临床护理路径应用于急性阑尾炎手术对患者术后伤口感染和并发症的影响。通过计算机检索 PubMed、Cochrane 图书馆、Web of Science、EMBASE、万方、中国生物医学文献数据库和中国知网，从数据库建立到 2023 年 10 月，收集临床护理路径应用于急性阑尾炎手术的随机对照试验（RCT）。两名研究人员独立进行文献筛选、数据提取和纳入文献质量评估。采用 RevMan 5.4 软件进行数据分析。最终纳入 21 项 RCT，共 2408 例患者。分析结果显示，实施临床护理路径可有效降低伤口感染发生率（OR=0.26，95%CI：0.15-0.46，p<0.001）和术后并发症发生率（OR=0.20，95%CI：0.15-0.27，p<0.001），缩短住院时间（MD=-3.26，95%CI：-3.74 至-2.79，p<0.001）和首次通气时间（MD=-14.85，95%CI：-21.56 至-8.13，p<0.001），显著提高患者满意度（OR=5.52，95%CI：3.52-8.65，p<0.001）。临床护理路径在急性阑尾炎手术中的应用可显著降低术后伤口感染和并发症发生率，同时缩短住院时间，提高患者满意度。
