我国二级以上医疗机构剖宫产术后手术部位感染发病率的Meta分析

目的评价2009年以来我国二级及以上医疗机构剖宫产术后手术部位感染(SSI)发生现状,为医院感染监控工作的开展提供数据支持。方法系统检索中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库、万方数据资源库及PubMed资源系统中2009年以后发表的、有关剖宫产术后SSI的研究文献,参考疾病患病率或发病率研究质量评价准则评价文献质量,采用Meta分析估计SSI合并发生率,并根据医疗机构等级进行亚组分析。结果共纳入文献61篇,19篇质量评分为7分,36篇为6分,6篇为5分,纳入文献整体质量较好。总样本量173 319例,2 860例发生了SSI,剖宫产术后SSI发生率为1.8%95%CI:(1.6%,2.0%)]。亚组分析显示,二级医疗机构SSI发生率2.3%95%CI:(1.8%,2.7%)]高于三级医疗机构1.4%95%CI(1.2%,1.7%)]。结论我国二级及以上医疗机构剖宫产术后SSI发生率较高,且不同级别医疗机构发生率不同,应按实际情况制定不同的监测基线,科学指导感控工作的开展。

Meta analysis on incidence of surgical site infection after cesarean section in secondary and above medical institutions in China

ObjectiveTo evaluate the occurrence of surgical site infection (SSI) after cesarean section in secondary and above medical institutions in China since 2009, and provide data support for monitoring healthcare associated infection(HAI). MethodsLiteratures on SSI following cesarean section published after 2009 were retrieved from China National Knowledge Infrastructure (CNKI), Chinese Science&Technology Journal Database (VIP), Wanfang Database, and PubMed, quality of literatures was evaluated by referring to disease incidence or morbidity quality evaluation criteria, combined incidence of SSI was estimated by Meta analysis, subgroup analysis was performed according to the levels of the medical institutions. ResultsA total of 61 literatures were included in the study, 19, 36, and 6 literatures were with quality scores of 7, 6, and 5 respectively, the overall quality of literatures was better. The total sample size was 173 319 cases, 2 860 cases occurred SSI, incidence of SSI after cesarean section was 1.8%(95%CI［1.6%，2.0%］）. Subgroup analysis showed that incidence of HAI in secondary medical institutions was 2.3%(95% CI［1.8%，2.7%］）, which was higher than 1.4%(95%CI［1.2%，1.7%］）of tertiary medical institutions. ConclusionIncidence of SSI after cesarean section in secondary and above medical institutions in China is high, and is different among different levels of medical institutions. Different monitoring baselines should be established according to actual condition, so as to guide HAI control work scientifically.