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中华关节外科杂志(电子版)

中华关节外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (03) : 302 -306. doi: 10.3877/cma.j.issn.1674-134X.2021.03.007

荟萃分析

髋关节置换术后引流与术后感染相关性的荟萃分析
刘小垒1, 周义钦2, 钱齐荣2,†()   
  1. 1. 200129　上海开元骨科医院关节外科
    2. 200003　上海长征医院关节外科
  • 收稿日期:2020-12-17 出版日期:2021-06-01
  • 通信作者: 钱齐荣

Meta-analysis of association between drainage and postoperative infection after hip replacement

Xiaolei Liu1, Yiqin Zhou2, Qirong Qian2,†()   

  1. 1. Department of joint surgery, Shanghai kaiyuan orthopaedic hospital, Shanghai 200129, China
    2. Department of joint surgery, Shanghai changzheng hospital, Shanghai 200003, China
  • Received:2020-12-17 Published:2021-06-01
  • Corresponding author: Qirong Qian
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引用本文：

刘小垒, 周义钦, 钱齐荣. 髋关节置换术后引流与术后感染相关性的荟萃分析[J]. 中华关节外科杂志(电子版), 2021, 15(03): 302-306.

Xiaolei Liu, Yiqin Zhou, Qirong Qian. Meta-analysis of association between drainage and postoperative infection after hip replacement[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2021, 15(03): 302-306.

目的

评价髋关节置换术后引流与否与术后感染相关性。

方法

检索PUBMED、Cochrane图书馆、中国知网数据库、重庆维普中文科技期刊数据库和万方数据库从建库至2019年12月31日髋关节置换术后引流与不引流的高质量随机对照试验，筛选结局指标中包含引流组和不引流组术后感染率的研究进行分析。偏倚风险评价应用Cochrane评价员手册。应用RevMan 5.3软件对术后感染率指标进行Meta分析。

结果

符合纳入标准的文献共15篇。Meta分析结果显示，引流组和不引流组比较，术后感染率差异无统计学意义[相对危险度(RR)＝1.04，95%置信区间(CI)(0.64，1.69)，P＝0.87]。

结论

髋关节置换术后放置引流管与不引流相比并不能降低术后感染率。需要更多多中心、大样本随机对照试验来获取最佳证据。

关键词: 关节成形术, 置换, 髋, 引流术, 外科伤口感染, Meta分析
Objective

To evaluate the correlation between drainage and postoperative infection after hip arthroplasty.

Methods

PUBMED, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, the Chongqing VIP database and Wanfang Data from the inception of each database up to 31 December 2019 were electronically searched. High-quality randomized clinical trials (RCTs) of drainage and non-drainage after hip arthroplasty, which evaluated indicators of postoperative infection were included. The Cochrane risk of bias tool was used to assess the risk of bias. The Cochrane Collaboration’s RevMan5.3 software was used for meta-analysis.

Results

Fifteen studies were included and made a meta-analysis. The meta-analysis results showed no significant difference in postoperative infection rate between the drainage group and the non-drainage group[ relative risk (RR)=1.04, 95% confidence interval (CI) (0.64, 1.69), P=0.87].

Conclusion

Drainage after hip arthroplasty did not reduce the postoperative infection rate compared with the non-drainage group. More central, large sample RCTs are needed to obtain the best evidence.

Key words: Arthroplasty, replacement, hip, Drainage, Surgical wound infection, Meta-analysis
图1 文献筛选流程图
表1 纳入研究的基本特征
纳入研究 发表时间 引流组例数 不引流组例数 随访时间
Beer [9] 1991 12 12 3个月
Murphy [14] 1993 18 19 10 d
Ritter [15] 1994 78 62 出院
Ovadia [16] 1997 18 12 出院
Kim [18] 1998 48 48 15个月
Crevoisier [17] 1998 33 33 出院
Niskanen [19] 2000 27 31 2个月
Widman [20] 2002 10 12 未提及
Gonzalez [21] 2004 53 51 3个月
Johansson [23] 2005 54 51 2个月
Walmsley [22] 2005 282 295 36个月
Dora [2] 2007 50 50 12个月
Strahovnik [8] 2010 97 42 3个月
Cheung [24] 2010 52 48 12个月
Kleinert [25] 2012 40 40 3个月
图2 纳入研究的偏倚风险图
图3 纳入研究的偏倚风险概况图
表2 纳入研究的偏倚风险
纳入研究 发表时间 随机序列的产生 分配隐藏 参与者盲法 评估者盲法 结局数据完整性 选择报告 其他偏倚
Beer [9] 1991 U U H L L U L
Murphy [14] 1993 L U H L L U L
Ritter [15] 1994 L U H L L U L
Ovadia [16] 1997 L U H L L U L
Kim [18] 1998 U U H L L U L
Crevoisier [17] 1998 L U H L L U L
Niskanen [19] 2000 U U H L L U L
Widman [20] 2002 L U H L L U L
Gonzalez [21] 2004 L U H L L U L
Johansson T[23] 2005 L U H L L U L
Walmsley [22] 2005 U U H L L U L
Dora [2] 2007 U U H L L U L
Strahovnik [8] 2010 L U H L L U L
Cheung [24] 2010 L U H L L U L
Kleinert [25] 2012 L U H L L U L
图4 引流组和不引流组术后感染率对比森林图
图5 引流组和不引流组术后感染率对比漏斗图
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