目的:系统评价在人工关节置换术中应用聚维酮碘溶液冲洗预防术后感染的效果。方法:应用计算机检索中国知网、万方数据库、PubMed、Embase、Web of Science和Cochrane Library中关于在人工关节置换术中应用聚维酮碘溶液冲洗预防术后感染的对比研究文献，检索时限均为建库至2023年11月1日。试验组术中采用聚维酮碘溶液冲洗，对照组术中采用其他冲洗液冲洗。依据文献检索及筛选方案筛选出符合要求的文献后，由2名研究人员分别独立进行数据提取和质量评价。采用RevMan5。3软件进行Meta分析。结果:共检索到601篇文献，最终纳入14篇，共涉及61 471例患者，其中试验组20 110例、对照组41 361例。2组总感染发生率、假体周围感染发生率、切口延迟愈合或不愈合发生率、二次手术率的组间比较，差异均无统计学意义[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]，试验组浅层感染发生率低于对照组[OR=0。52，95％CI(0。30，0。89)，P=0。020]。结论:现有证据表明，与其他冲洗液相比，在人工关节置换术中应用聚维酮碘溶液冲洗并不能显著减少术后假体周围感染和切口延迟愈合或不愈合的发生，但能减少术后浅层感染的发生。
Efficacy of rinse with povidone-iodine solution in artificial joint replacement for prevention of postoperative in-fection:a meta-analysis
Objective:To systematically review the clinical efficacy of rinse with povidone-iodine(PVP-Ⅰ)solution in artificial joint re-placement 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 replace-ment.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 in-cluded 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 inci-dences 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.
arthroplasty,replacementprosthesis-related infectionssurgical wound infectionpovidone-iodinemeta-analysis as topic
万方数据
维普
