84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]嚴(yán)坤,張子義,冉建.在人工關(guān)節(jié)置換術(shù)中應(yīng)用聚維酮碘溶液沖洗預(yù)防術(shù)后感染效果的Meta分析[J].中醫(yī)正骨,2024,36(02):49-54.
 YAN Kun,ZHANG Ziyi,RAN Jian.Efficacy of rinse with povidone-iodine solution in artificial joint replacement for prevention of postoperative infection:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(02):49-54.
點(diǎn)擊復(fù)制

在人工關(guān)節(jié)置換術(shù)中應(yīng)用聚維酮碘溶液沖洗預(yù)防術(shù)后感染效果的Meta分析()
分享到:

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期數(shù):
2024年02期
頁(yè)碼:
49-54
欄目:
文獻(xiàn)研究
出版日期:
2024-02-20

文章信息/Info

Title:
Efficacy of rinse with povidone-iodine solution in artificial joint replacement for prevention of postoperative infection:a meta-analysis
作者:
嚴(yán)坤張子義冉建
(新疆醫(yī)科大學(xué)第六附屬醫(yī)院,新疆 烏魯木齊 830002)
Author(s):
YAN KunZHANG ZiyiRAN Jian
The Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830002,Xinjiang,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù)置換 假體相關(guān)感染 外科傷口感染 聚維酮碘 專題Meta分析
Keywords:
arthroplastyreplacement prosthesis-related infections surgical wound infection povidone-iodine meta-analysis as topic
摘要:
目的:系統(tǒng)評(píng)價(jià)在人工關(guān)節(jié)置換術(shù)中應(yīng)用聚維酮碘溶液沖洗預(yù)防術(shù)后感染的效果。方法:應(yīng)用計(jì)算機(jī)檢索中國(guó)知網(wǎng)、萬(wàn)方數(shù)據(jù)庫(kù)、PubMed、Embase、Web of Science和Cochrane Library中關(guān)于在人工關(guān)節(jié)置換術(shù)中應(yīng)用聚維酮碘溶液沖洗預(yù)防術(shù)后感染的對(duì)比研究文獻(xiàn),檢索時(shí)限均為建庫(kù)至2023年11月1日。試驗(yàn)組術(shù)中采用聚維酮碘溶液沖洗,對(duì)照組術(shù)中采用其他沖洗液沖洗。依據(jù)文獻(xiàn)檢索及篩選方案篩選出符合要求的文獻(xiàn)后,由2名研究人員分別獨(dú)立進(jìn)行數(shù)據(jù)提取和質(zhì)量評(píng)價(jià)。采用RevMan5.3軟件進(jìn)行Meta分析。結(jié)果:共檢索到601篇文獻(xiàn),最終納入14篇,共涉及61 471例患者,其中試驗(yàn)組20 110例、對(duì)照組41 361例。2組總感染發(fā)生率、假體周圍感染發(fā)生率、切口延遲愈合或不愈合發(fā)生率、二次手術(shù)率的組間比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義[OR=0.68,95%CI(0.43,1.07),P=0.090; OR=0.68,95%CI(0.38,1.23),P=0.210; OR=2.08,95%CI(0.73,5.96),P=0.170; OR=1.18,95%CI(0.92,1.51),P=0.200],試驗(yàn)組淺層感染發(fā)生率低于對(duì)照組[OR=0.52,95%CI(0.30,0.89),P=0.020]。結(jié)論:現(xiàn)有證據(jù)表明,與其他沖洗液相比,在人工關(guān)節(jié)置換術(shù)中應(yīng)用聚維酮碘溶液沖洗并不能顯著減少術(shù)后假體周圍感染和切口延遲愈合或不愈合的發(fā)生,但能減少術(shù)后淺層感染的發(fā)生。
Abstract:
Objective:To systematically review the clinical efficacy of rinse with povidone-iodine(PVP-I)solution in artificial joint replacement for preventing postoperative infection.Methods:All the comparative study articles about rinse with PVP-I solution in artificial joint replacement against postoperative infection included from database establishing to November 1,2023 were retrieved from the China National Knowledge Internet,Wanfang Database,PubMed,Embase,Web of Science and Cochrane Library through computer.The patients in experiment group were rinsed with PVP-I solution,while the ones in control group with other flushing solutions in the artificial joint replacement.The articles were screened according to the retrieval and screening scheme.The information was extracted and the methodological quality of included researches in the articles was evaluated independently by two researchers,and then a Meta-analysis was conducted by using RevMan 5.3 software.Results:Six hundred and one articles were searched out.After screening,14 articles(61 471 patients)were included in the final analysis,20 110 patients in experiment group and 41 361 ones in control group.The results of Meta-analysis revealed that the differences in total infection incidence,periprosthetic infection incidence,incision delayed-union or nonunion incidence,and secondary surgery incidence were not statistically significant between the 2 groups(OR=0.68,95%CI(0.43,1.07),P=0.090; OR=0.68,95%CI(0.38,1.23),P=0.210; OR=2.08,95%CI(0.73,5.96),P=0.170; OR=1.18,95%CI(0.92,1.51),P=0.200),while,the superficial infection incidence was lower in experiment group compared to control group(OR=0.52,95%CI(0.30,0.89),P=0.020).Conclusion:Available evidences suggest that rinse with PVP-I solution in artificial joint replacement can not significantly reduce the incidences of postoperative periprosthetic infection and delayed-union or nonunion of incision,but it can reduce the incidence of postoperative superficial infection in contrast to other flushing solutions.

參考文獻(xiàn)/References:

[1] KIM C H,KIM H,LEE S J,et al.The effect of povidone-iodine lavage in preventing infection after total hip and knee arthroplasties:systematic review and meta-analysis[J].J Arthroplasty,2020,35(8):2267-2273.
[2] WANG D,HUANG X,LV W,et al.The toxicity and antibacterial effects of povidone-iodine irrigation in fracture surgery[J].Orthop Surg,2022,14(9):2286-2297.
[3] PARVIZI J,SALEH K J,RAGLAND P S,et al.Efficacy of antibiotic-impregnated cement in total hip replacement[J].Acta Orthop,2008,79(3):335-341.
[4] WANG P,WANG D,ZHANG L.Effectiveness of chlorhexidine versus povidone-iodine for preventing surgical site wound infection:a meta-analysis[J/OL].Int Wound J,2023[2023-10-12].https://pubmed.ncbi.nlm.nih.gov/37752735/.
[5] CALKINS T E,CULVERN C,NAM D,et al.Dilute betadine lavage reduces the risk of acute postoperative periprosthetic joint infection in aseptic revision total knee and hip arthroplasty:a randomized controlled trial[J].J Arthroplasty,2020,35(2):538-543.
[6] HERNANDEZ N M,HART A,TAUNTON M J,et al.Use of povidone-iodine irrigation prior to wound closure in primary total hip and knee arthroplasty:an analysis of 11,738 cases[J].J Bone Joint Surg Am,2019,101(13):1144-1150.
[7] FOURNEL I,TIV M,SOULIAS M,et al.Meta-analysis of intraoperative povidone-iodine application to prevent surgical-site infection[J].Br J Surg,2010,97(11):1603-1613.
[8] MOONEY J A,PRIDGEN E M,MANASHEROB R,et al.Periprosthetic bacterial biofilm and quorum sensing[J].J Orthop Res,2018,36(9):2331-2339.
[9] KHEIR M M,TAN T L,ACKERMAN C T,et al.Culturing periprosthetic joint infection:number of samples,growth duration,and organisms[J].J Arthroplasty,2018,33(11):3531-3536.
[10] BERGER V W.Is the Jadad score the proper evaluation of trials?[J].J Rheumatol,2006,33(8):1710-1711.
[11] 曾憲濤,莊麗萍,楊宗國(guó),等.Meta分析系列之七:非隨機(jī)實(shí)驗(yàn)性研究、診斷性試驗(yàn)及動(dòng)物實(shí)驗(yàn)的質(zhì)量評(píng)價(jià)工具[J].中國(guó)循證心血管醫(yī)學(xué)雜志,2012,4(6):496-499.
[12] HART A,HERNANDEZ N M,ABDEL M P,et al.Povidone-iodine wound lavage to prevent infection after revision total hip and knee arthroplasty:an analysis of 2,884 cases[J].J Bone Joint Surg Am,2019,101(13):1151-1159.
[13] BROWN N M,CIPRIANO C A,MORIC M,et al.Dilute betadine lavage before closure for the prevention of acute postoperative deep periprosthetic joint infection[J].J Arthroplasty,2012,27(1):27-30.
[14] DRIESMAN A,SHEN M,FENG J E,et al.Perioperative chlorhexidine gluconate wash during joint arthroplasty has equivalent periprosthetic joint infection rates in comparison to betadine wash[J].J Arthroplasty,2020,35(3):845-848.
[15] FRISCH N B,KADRI O M,TENBRUNSEL T,et al.Intra-operative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty[J].Arthroplast Today,2017,3(4):294-297.
[16] HOFMANN K J,HAYDEN B L,KONG Q,et al.Triple prophylaxis for the prevention of surgical site infections in total joint arthroplasty[J].Current Orthopaedic Practice,2017,28(1):66-69.
[17] LUNG B E,LE R,CALLAN K,et al.Chlorhexidine gluconate lavage during total joint arthroplasty may improve wound healing compared to dilute betadine[J].J Exp Orthop,2022,9(1):67.
[18] MATSEN KO L J,YOO J Y,MALTENFORT M,et al.The effect of implementing a multimodal approach on the rates of periprosthetic joint infection after total joint arthroplasty[J].J Arthroplasty,2016,31(2):451-455.
[19] MUWANIS M,BARIMANI B,LUO L,et al.Povidone-iodine irrigation reduces infection after total hip and knee arthroplasty[J].Arch Orthop Trauma Surg,2023,143(4):2175-2180.
[20] SHOHAT N,GOH G S,HARRER S L,et al.Dilute povidone-iodine irrigation reduces the rate of periprosthetic joint infection following hip and knee arthroplasty:an analysis of 31,331 cases[J].J Arthroplasty,2022,37(2):226-231.
[21] SLULLITEL P A,DOBRANSKY J S,BALI K,et al.Is there a role for preclosure dilute betadine irrigation in the prevention of postoperative infection following total joint arthroplasty?[J].J Arthroplasty,2020,35(5):1374-1378.
[22] WINKLER C,DENNISON J,WOOLDRIDGE A,et al.Do local antibiotics reduce periprosthetic joint infections?A retrospective review of 744 cases[J].J Clin Orthop Trauma,2018,9(Suppl 1):S34-S39.
[23] 羅旭,陳偉,韓浩,等.人工關(guān)節(jié)置換術(shù)中碘伏處理創(chuàng)口對(duì)預(yù)防假體周圍感染的臨床效果評(píng)價(jià)[J].中外醫(yī)學(xué)研究,2020,18(22):27-30.
[24] CICHOS K H,ANDREWS R M,WOLSCHENDORF F,et al.Efficacy of intraoperative antiseptic techniques in the prevention of periprosthetic joint infection:superiority of betadine[J].J Arthroplasty,2019,34(7s):S312-S318.
[25] 王利宏,單軍標(biāo),周方倫,等.聚維酮碘間斷灌洗治療人工關(guān)節(jié)置換術(shù)后早期假體周圍感染[J].中華骨科雜志,2020,40(13):840-847.
[26] SEIDELMAN J L,MANTYH C R,ANDERSON D J.Surgical site infection prevention:a review[J].JAMA,2023,329(3):244-252.
[27] FUSE Y,OGAWA H,TSUKAHARA Y,et al.Iodine metabolism and thyroid function during the perinatal period:maternal-neonatal correlation and effects of topical povidone-iodine skin disinfectants[J].Biol Trace Elem Res,2023,201(6):2685-2700.
[28] MARCHIONATTI E,CONSTANT C,STEINER A.Preoperative skin asepsis protocols using chlorhexidine versus povidone-iodine in veterinary surgery:a systematic review and meta-analysis[J].Vet Surg,2022,51(5):744-752.
[29] CHUNDAMALA J,WRIGHT J G.The efficacy and risks of using povidone-iodine irrigation to prevent surgical site infection:an evidence-based review[J].Can J Surg,2007,50(6):473-481.
[30] 步子恒,黃軒,胡宏悻,等.髖關(guān)節(jié)置換術(shù)中碘伏沖洗對(duì)患者甲狀腺功能的影響[J].中華關(guān)節(jié)外科雜志(電子版),2019,13(2):151-156.
[31] LABRECQUE S,SHAH S,FERGUS D,et al.Mupirocin susceptibility of staphylococci 2022:is it time for a change in MRSA decolonization protocols?[J]Am J Infect Control,2023,51(7):725-728.

相似文獻(xiàn)/References:

[1]邢金明.切開(kāi)復(fù)位鎖定鋼板內(nèi)固定術(shù)和人工半肩關(guān)節(jié)置換術(shù) 治療老年肱骨近端復(fù)雜骨折的對(duì)比研究[J].中醫(yī)正骨,2015,27(08):11.
 XING Jinming.A retrospective trial of open reduction and locking plate internal fixation versus artificial shoulder hemiarthroplasty for complicated proximal humeral fractures in old patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):11.
[2]趙云昌.人工股骨頭置換治療老年粉碎性股骨轉(zhuǎn)子間骨折[J].中醫(yī)正骨,2015,27(08):31.
[3]張明強(qiáng).生物型加長(zhǎng)柄半髖關(guān)節(jié)置換術(shù)治療 高齡不穩(wěn)定股骨轉(zhuǎn)子間骨折療效觀察[J].中醫(yī)正骨,2015,27(02):56.
[4]蔡云仙.圍手術(shù)期耳穴按壓聯(lián)合平衡針療法 在全膝關(guān)節(jié)置換術(shù)后鎮(zhèn)痛中的應(yīng)用[J].中醫(yī)正骨,2015,27(06):41.
[5]喻長(zhǎng)純,楊明路,王戰(zhàn)朝.不同手術(shù)方式治療脛骨平臺(tái)骨折畸形愈合的體會(huì)[J].中醫(yī)正骨,2015,27(03):37.
[6]魏瑄,宋樹(shù)春,王金良.術(shù)前精確測(cè)量和評(píng)估在全髖關(guān)節(jié)置換治療 成人發(fā)育性髖關(guān)節(jié)發(fā)育不良繼發(fā)骨關(guān)節(jié)炎中的價(jià)值[J].中醫(yī)正骨,2015,27(01):30.
[7]鮑榮華,陳曉東,王國(guó)平,等.Wagner Cone生物型假體置換結(jié)合經(jīng)股骨轉(zhuǎn)子下橫形截骨 治療CroweⅣ型成人發(fā)育性髖關(guān)節(jié)發(fā)育不良[J].中醫(yī)正骨,2015,27(01):33.
[8]喻長(zhǎng)純,楊明路,王戰(zhàn)朝.同期髕骨脫位矯正術(shù)聯(lián)合全膝關(guān)節(jié)置換術(shù)治療 晚期膝骨關(guān)節(jié)炎合并習(xí)慣性髕骨脫位[J].中醫(yī)正骨,2015,27(01):41.
[9]武理國(guó),沈軍,傅國(guó)海,等.人工肱骨頭置換治療老年肱骨近端復(fù)雜骨折[J].中醫(yī)正骨,2013,25(10):70.
[10]李國(guó)梁,韓廣普,閆國(guó)強(qiáng),等.紅花化瘀湯薰蒸聯(lián)合理筋手法 在膝骨關(guān)節(jié)炎全膝關(guān)節(jié)置換術(shù)后康復(fù)中的應(yīng)用[J].中醫(yī)正骨,2013,25(12):31.
 Li Guoliang*,Han Guangpu,Yan Guoqiang,et al.Clinical application of HONGHUAHUAYU decoctions steaming combined with sinew adjusting manipulation in the postoperative rehabilitation of total knee arthroplasty in patients with knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(02):31.
[11]樊慶陽(yáng),任凱晶.定制3D打印切模輔助全膝關(guān)節(jié)置換術(shù)治療 膝骨關(guān)節(jié)炎合并股骨干骨折畸形愈合[J].中醫(yī)正骨,2015,27(11):37.
[12]李翰林,童培建.利福平聯(lián)合用藥配合保留假體清創(chuàng)治療 人工關(guān)節(jié)置換術(shù)后早期感染及低毒性感染[J].中醫(yī)正骨,2015,27(09):56.
[13]劉曉雅,孫永強(qiáng),劉國(guó)杰.主動(dòng)快速康復(fù)鍛煉對(duì)全膝關(guān)節(jié)置換術(shù)后關(guān)節(jié)活動(dòng)度的影響[J].中醫(yī)正骨,2015,27(09):73.
[14]張維平,康兩期,陳衛(wèi),等.全髖關(guān)節(jié)置換術(shù)圍手術(shù)期隱性失血的研究進(jìn)展[J].中醫(yī)正骨,2015,27(08):61.
[15]宋兵華,孫俊英,倪增良,等.全膝關(guān)節(jié)置換術(shù)前CT測(cè)量股骨后髁角的臨床意義[J].中醫(yī)正骨,2015,27(07):38.
[16]王金良,孫京濤,李玲,等.骨水泥聯(lián)合螺釘修復(fù)全膝關(guān)節(jié)置換術(shù)中 脛骨平臺(tái)內(nèi)側(cè)骨缺損[J].中醫(yī)正骨,2015,27(12):55.
[17]徐偉鋒,葉健,吳連國(guó).強(qiáng)骨飲對(duì)骨質(zhì)疏松性股骨頸骨折患者全髖關(guān)節(jié)置換術(shù)后 血清骨代謝生化指標(biāo)和骨密度的影響[J].中醫(yī)正骨,2015,27(02):12.
 XU Weifeng,YE Jian,WU Lianguo.Effect of Qianggu Yin(強(qiáng)骨飲,QGY)on serum bone metabolism indexes and bone density after total hip arthroplasty in patients with osteoporotic femoral neck fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):12.
[18]張榮,王健.人工全膝關(guān)節(jié)置換術(shù)的圍手術(shù)期心理護(hù)理[J].中醫(yī)正骨,2015,27(05):77.
[19]齊志遠(yuǎn),陳秀民,王在斌,等.桃紅四物加黃芪湯預(yù)防人工髖膝關(guān)節(jié)置換術(shù)后 下肢深靜脈血栓形成[J].中醫(yī)正骨,2015,27(03):71.
[20]陸吳超,季衛(wèi)鋒,馬鎮(zhèn)川.關(guān)節(jié)鏡下清創(chuàng)后持續(xù)灌洗聯(lián)合中藥口服治療 全膝關(guān)節(jié)置換術(shù)后急性期感染[J].中醫(yī)正骨,2015,27(01):51.

備注/Memo

備注/Memo:
通訊作者:冉建 E-mail:ranjianxj@126.com
更新日期/Last Update: 1900-01-01