摘要
目的总结关节置换术后手术部位感染预防的证据,为临床实践提供参考依据。方法检索BMJ Best Practice、Up to Date,BMJ Clinical Evidence、世界卫生组织(WHO)、国际指南协作网(GIN)、英国国家卫生与临床优化研究所(NICE)、美国国立指南库(NGC)、加拿大安大略医学会(RNAO)、苏格兰院际间指南网(SIGN)、新西兰指南协作组(NZGG)、美国医师学会俱乐部(ACP Club)、Cochrane临床对照试验中心注册数据库、JBI循证卫生保健知识库、PubMed、Embase、CINAHL、中国知网、万方数据库、中国生物医学文献数据库以及欧洲灰色文献信息系统(SIGLE)中与髋、膝关节置换术后手术部位感染预防相关的证据,检索时间为近5年内,证据的提取和质量评价均由2名研究人员独立完成。结果共纳入11项研究,其中包括6篇循证指南、1篇专家共识、4篇系统评价。研究人员提炼出23条、3个方面(术前、术中、术后)髋、膝关节置换术后手术部位感染的预防证据,A级推荐11条,B级推荐12条。结论最佳证据显示,目前髋、膝关节置换术后手术部位感染的原因众多,严重的手术部位感染会阻碍加速康复的进程,证据应用者应因地制宜,精准把握术前、术中和术后的每一个环节,优化手术与护理流程以预防手术部位感染。
Objective To summarize the evidence of prevention of surgical site infection(SSI)after total joint arthroplasty,provide reference basis for clinical practice.Methods Evidence related to the prevention of SSI after hip and knee arthroplasty were retrieved from BMJ Best Practice,Up to Date,BMJ Clinical Evidence,World Health Organization(WHO),Guidelines International Network(GIN),National Institute for Health and Clinical Excellence(NICE),National Guideline Clearinghouse(NGC),Registered Nurse’s Association of Ontario(RNAO),Scottish Intercollegiate Guidelines Network(SIGN),New Zealand Guidelines Group(NZGG),American College of Physicians(ACP)Club,The Cochrane Central Register of Controlled Trials(CENTRAL),The JBI Model of Evidence Based Healthcare,PubMed,Embase,Cumulative Index to Nursing and Allied Health Literature(CINAHL),China National Knowledge Infrastructure(CNKI),Wanfang Data,Chinese Biomedical Literature Datbase(CBM),and System for Information on Grey Literature in Europe(SIGLE).The retrieval time was in recent 5 years,evidence extraction and quality evaluation were completed independently by two researchers.Results A total of 11 studies were involved,including 6 evidence-based guidelines,1 expert consensus and 4 systematic reviews.The researchers extracted 23 pieces of evidence for the prevention of SSI after hip and knee arthroplasty in 3 aspects(pre-operative,intra-operative and post-operative),11 of which were grade A recommendations and 12 of which were grade B recommendations.Conclusion The best evidence shows that there are multiple factors for SSI after hip and knee arthroplasty,severe SSI will hinder the process of enhanced recovery,evidence users should adjust measures according to local conditions,accurately grasp every link before,during,and after surgery,optimize the surgical and nursing procedures to prevent SSI.
作者
付中敏
宁宁
陈佳丽
周宗科
胡蓉
高梦徽
李佩芳
雷蕾
FU Zhong-min;NING Ning;CHEN Jia-li;ZHOU Zong-ke;HU Rong;GAO Meng-hui;LI Pei-fang;LEI Lei(West China School of Nursing,Sichuan University,Chengdu 610041,China;Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China;Sichuan Key Laboratory of Nursing,Sichuan University,Chengdu 610041,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2022年第6期554-561,共8页
Chinese Journal of Infection Control
基金
四川省科技厅重点研发项目(2021YFS0068)
四川大学华西医院学科卓越发展1.3.5工程护理学科发展专项基金(HXHL20003)。
关键词
加速康复
髋关节置换术
膝关节置换术
手术部位感染
证据
循证护理
enhanced recovery
hip arthroplasty
knee arthroplasty
surgical site infection
evidence
evidence-based nursing
