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腹腔镜手术中预防皮下气肿发生的最佳证据总结。

Summary of the best evidence for preventing the occurrence of subcutaneous emphysema in laparoscopic surgery.

机构信息

Shanghai East Hospital, Tongji University School of Medicine, China.

Shanghai East Hospital, Tongji University School of Medicine, China.

出版信息

Asian J Surg. 2024 Oct;47(10):4295-4299. doi: 10.1016/j.asjsur.2024.07.199. Epub 2024 Aug 20.

Abstract

To retrieve, analyze, and extract evidence related to subcutaneous emphysema in patients undergoing laparoscopic surgery systematically, and provide evidence-based recommendations for reducing its incidence. By browsing the websites of the National Institute for Health and Clinical Excellence, the International Guideline Collaboration Network, the National Guideline Library of the United States, the Registered Nurses Association of Ontario, the Scottish Intercollegiate Guideline Network, the Clinical Practice Guidelines website of the Canadian Medical Association, UpToDate, Web of Science, PubMed, OVID, Cochrane Library, Embase, Chinese Biomedical Database, CNKI, VIP, and Wanfang Database, relevant literatures, guidelines, systematic reviews, evidence summaries, expert consensus, randomized controlled trials, etc. about subcutaneous emphysema in patients undergoing laparoscopic surgery were retrieved. All searches were limited to articles published between 1st January 2010 to 1st August 2023. 2245 articles were identified in total, 10 articles were included after exclude literature that does not meet the standards, including 3 clinical decision-making articles, 2 review papers, and 5 randomized controlled trials. Evidence summarization was conducted from 5 aspects: influencing factors, prevention, establishment and management of pneumoperitoneum, intraoperative monitoring, and intervention methods, 15 pieces of best evidences were summarized. Clinical staffs should transform and apply the evidence-based practices to decrease the incidence of subcutaneous emphysema and enhance the quality of life for patients.

摘要

为了系统地检索、分析和提取腹腔镜手术患者皮下气肿相关证据,并为降低其发生率提供循证推荐,检索了国家卫生健康临床研究与转化医学中心、国际指南协作网、美国国家指南库、安大略注册护士协会、苏格兰校际指南网络、加拿大医学会临床实践指南网站、UpToDate、Web of Science、PubMed、OVID、Cochrane 图书馆、Embase、中国生物医学文献数据库、中国知网、维普及万方数据库中关于腹腔镜手术患者皮下气肿的相关文献、指南、系统评价、证据总结、专家共识、随机对照试验等。所有检索均限定于 2010 年 1 月 1 日至 2023 年 8 月 1 日期间发表的文章。共检索到 2245 篇文章,排除不符合标准的文献后,纳入 10 篇文献,包括 3 篇临床决策文章、2 篇综述和 5 篇随机对照试验。从影响因素、预防、气腹建立和管理、术中监测和干预方法 5 个方面进行证据总结,共总结 15 项最佳证据。临床工作人员应转变并应用循证实践,以降低皮下气肿的发生率,提高患者的生活质量。

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