上海护理2024，Vol.24Issue(1)：42-52,11.DOI:10.3969/j.issn.1009-8399.2024.01.010
术前造口定位对肠造口患者并发症发生率影响的Meta分析
Meta-analysis of the Effect of Preoperative Positioning of Enterostomy on Postoperative Complication Rate
摘要
Abstract
Objective To evaluate the effect of preoperative positioning of enterostomy on postoperative stoma-related complication rate,aiming to establish evidence-based clinical practice.Methods Relevant articles were retrieved from CNKI,Wanfang Data,VIP,CBMdisc,PubMed,Cochrane Library,CINAHL,Embase,Ovid Emcare and British Nursing Index from their establishment to June 15,2022.Subsequently,the retrieved articles underwent screening,data extraction and quality evaluation by two independent researchers and then statistical analysis using RevMan(v5.3).Results A total of 32 articles were included.The Meta-analysis showed that preoperative positioning effectively reduced the overall stoma-related complication rate[RR=0.38,95%CI(0.28,0.53),P<0.01],the peristomal skin complication rate[RR=0.47,95%CI(0.29,0.75),P<0.01],the stoma leakage rate[RR=0.20,95%CI(0.09,0.45),P<0.01,the mucocutaneous separation rate[RR=0.28,95%CI(0.13,0.61),P<0.01],the stoma retraction rate[RR=0.50,95%CI(0.27,0.92),P=0.03],the stoma stenosis rate[RR=0.27,95%CI(0.10,0.72),P<0.01],the parastomal hernia rate[RR=0.23,95%CI(0.14,0.36),P<0.01],the stoma prolapse rate[RR=0.38,95%CI(0.19,0.76),P<0.01]and the stoma bleeding rate[RR=0.26,95%CI(0.08,0.78),P=0.02].However,preoperative positioning did not significantly reduce the stoma ischemia rate[RR=0.45,95%CI(0.15,1.38),P= 0.16]and stoma edema rate.Conclusion Preoperative positioning of enterostomy can effectively reduce the overall stoma-related complication rate,the stoma/peristomal skin complication rate,parastomal hernia rate,stoma prolapse rate and stoma bleeding rate.However,there is no sufficient evidence to support its effectiveness in reducing stoma ischemia and stoma edema rates.关键词
肠造口术/术前造口定位/造口相关并发症/Meta分析Key words
Enterostomy/Preoperative ostomy positioning/Stoma-related complication/Meta-analysis分类
医药卫生引用本文复制引用
杨索,谌永毅,刘华云,朱小妹,刘阳,龚有文..术前造口定位对肠造口患者并发症发生率影响的Meta分析[J].上海护理,2024,24(1):42-52,11.基金项目
湖南省中医肿瘤护理研究生培养创新实践基地开放基金项目(湘教通2019-248) （湘教通2019-248）
湖南省中医伤口康复循证护理研究生联合培养基地项目(湘教通[2021]346号). （湘教通[2021]346号）
