标题：泡沫敷料与纱布敷料对气管切开患者伤口换药效果的Meta分析

      作者：左红霞 1，柯玉芳 2，段小丽 1，汪龙 1，张超 1    左红霞 1，柯玉芳 2，段小丽 1，汪龙 1，张超 11.十堰市太和医院(湖北医药学院附属医院)循证医学中心，湖北 十堰 442000；2.十堰市太和医院(湖北医药学院附属医院)妇科，湖北 十堰 442000

      卷次： 2024年35卷7期

      【摘要】 目的 系统评价泡沫敷料与纱布敷料对气管切开患者的伤口换药效果。方法 全面检索自建库至 2023年 6月 14日在 CBM、PubMed、EMBASE等国内外权威数据库的相关临床研究，按纳排标准筛选文献并提取数据，采用 RevMan软件进行Meta分析。结果 纳入 50项研究，共计 2 496例患者。Meta分析结果显示：气管切开患者泡沫敷料组的切口感染发生率(OR=0.17，95%CI：0.13~0.22，P<0.000 01)、肺部感染发生率(OR=0.25，95%CI：0.14~0.45，P<0.000 01)、切口周围皮肤并发症发生率 (OR=0.23，95%CI：0.19~0.28，P<0.000 01)、更换敷料频率 (MD=-2.61次 /d，95%CI：-3.33~-1.88，P<0.000 01)、拔管时间 (MD=-4.90 d，95%CI：-5.99~-3.80，P<0.000 01)和切口愈合时间(MD=-4.16 d，95%CI：-5.62~-2.71，P<0.000 01)均显著低于纱布敷料组，但换药间隔时间(MD=13.17 h，95%CI：10.69~15.65，P<0.000 01)明显长于纱布敷料组。结论 与传统无菌纱布敷料相比，泡沫敷料可显著降低气管切开患者的切口感染和肺部感染、减少切口周围皮肤并发症发生率，延长换药间隔时间，缩短更换敷料频率、缩短拔管时间，促进切口愈合。
      【关键词】 泡沫敷料；纱布敷料；气管切开；随机对照试验；Meta分析
      【中图分类号】 R653 【文献标识码】 A 【文章编号】 1003—6350（2024）07—1000—11

Wound dressing effect of foam dressing and sterile gauze in tracheostomy patients: a meta-analysis.
ZUOHong-xia 1, KE Yu-fang 2, DUAN Xiao-li 1, WANG Long 1, ZHANG Chao 1. 1. Department of Evidence-based Medicine andClinical Research, Shiyan Taihe Hospital, the Affiliated Hospital of Hubei University of Medicine, Shiyan 442000, Hubei,CHINA; 2. Department of Gynecology, Shiyan Taihe Hospital, the Affiliated Hospital of Hubei University of Medicine, Shiyan442000, Hubei, CHINA
【Abstract】 Objective To systematically review the wound dressing effect of foam dressing and sterile gauze intracheostomy patients. Methods Relevant clinical studies were comprehensively retrieved from CBM, PubMed, EM-BASE, and other authoritative databases from inception to 14 June, 2023 at home and abroad. Literatures were screenedaccording to inclusion and exclusion criteria, and meta-analysis was performed using RevMan software. Results A totalof 50 RCTs involving 2 496 tracheostomy patients were included. Meta-analysis showed that: the incidence of incision in-fection (OR=0.17, 95%CI: 0.13 to 0.22, P<0.000 01), pulmonary infection (OR=0.25, 95%CI: 0.14 to 0.45, P<0.000 01),skin complications around incision (OR=0.23, 95% CI: 0.19 to 0.28, P<0.000 01), frequency of changing dressing(MD=-2.61 times/d, 95%CI: -3.33 to -1.88, P<0.000 01), extubation time (MD=-4.90 d, 95%CI: -5.99 to -3.80, P<0.000 01), and incision healing time (MD=-4.16 d, 95%CI: -5.62 to -2.71, P<0.000 01) of patients in foam dressinggroup were all significantly lower than the sterile gauze group; while the dressing interval time (MD=13.17 h, 95%CI:10.69 to 15.65, P<0.000 01) in foam dressing group was significantly longer than that in the sterile gauze group.Conclusion Compared with the traditional sterile gauze group, the foam dressings can significantly reduce tracheoto-my patients’incision and lung infection, decrease the incidence of skin complications around incision, extend the dress-ing interval, shorten the frequency of changing dressing, shorten the extubation time, and promote wound healing.
      【Key words】 Foam dressing; Sterile gauze; Tracheostomy; Randomized controlled trials (RCTs); Meta-analysis