摘要
目的:对使用抗生素预防起搏器术后感染的有效性性进行系统评价。方法:在Pubmed、Cochrane Library临床对照试验资料库、中国生物医学文献数据库(CBM)、万方数据库进行检索。系统收集使用抗生素预防起搏器植入术后感染的相关文献,并按临床科研方法的国际通用原则进行阅读和评价。采用Cochrane协作网提供的软件Revman5进行Meta分析,以获得使用抗生素预防起搏器植入术后感染有效性指标的相关证据。结果:共检索到篇原始文献60,有6篇符合最终的入选标准,总计2259例随访患者例。纳入试验的方法学质量为B级2篇,C级4篇。Meta分析研究表明:①预防性使用抗生素可明显减少起搏器术后相关的各种感染风险[RR=0.29,95%CI(0.16,0.53)],明显减少皮肤切口和起搏器囊袋感染风险[RR=0.36,95%CI(0.19,0.67)];②在系统感染、败血症及感染性心内膜炎方面有减少的趋势,但比较差异无统计学意义[RR=0.24,95%CI(0.04,1.39)]。结论:现有的证据表明,预防性使用抗生素可显著减少起搏器术后各种相关感染的发生风险,尤其是囊袋感染及皮肤切口的感染的发生风险,但对败血症及细菌性心内膜炎的预防效果尚需临床试验进一步证实。
Objective To evaluate the efficacy of antibiotic prophylaxis for permanent pacemaker.Methods Randomized controlled trials （RCTs） were searched from the following electronic databases：PubMed,The Cochrane Library,CBM,and WanFang.We also handsearched the references of the included CRTs.Quality assessment and data extraction were conducted by two reviewers independently.Disagreement was resolved through discussion.All data were analyzed by using Review Manager 5 software.Results Six studies involving 2 259 participants met the inclusion criteria.Meta-analysis results showed that：①Compared with the control group,antibiotic prophylaxis significantly reduced the risk of all kinds of infection after permanent pacemaker implantation or generators replacement[RR=0.29,95%C1（0.16,0.53）],reduced the rate of superficial wound or pacemaker pocket infection[RR=0.36,95%CI（0.19,0.67）].②There were no significant differences in systemic infection, septicemia and infectious endocarditis [RR=0.24,95%CI（0.04,1.39））.Conclusion Antibiotic prophylaxis significantly reduced the incidence of infective complications of all kinds of infection,especially superficial wound or pacemaker pocket infection.More RCTs need to perform to clarify the effects of antibiotic prophylaxis on systemic infection,septicemia and infectious endocarditis.
出处
《吉林医学》
CAS
2010年第21期3416-3418,共3页
Jilin Medical Journal
