术前造口定位对肠造口患者并发症发生率影响的meta分析

目的：评价术前造口定位对肠造口患者造口相关并发症发生率影响，为临床实践提供循证依据。 方法：检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、Pubmed、Cochrane Library、CINAHL、Embase、Ovid Emcare、British Nursing Index，检索时限为建库至2022年6月15日。由2名研究者独立进行文献筛选、资料提取和质量评价后，采用RevMan 5.3软件进行统计分析。结果：共纳入32篇文献，Meta分析结果显示，术前造口定位可有效降低造口相关并发症总发生率RR=0.38,95%CI(0.28,0.53),P<0.00001]、造口周围皮肤并发症发生率RR=0.47,95%CI(0.29,0.75),P=0.002]、造口渗漏发生率RR=0.20,95%CI(0.09,0.45),P<0.0001]、皮肤黏膜分离发生率RR=0.28,95%CI(0.13,0.61),P=0.002]、造口回缩发生率RR=0.50,95%CI(0.27,0.92),P=0.03]、造口狭窄发生率RR=0.27,95%CI(0.10,0.72),P=0.009]、造口旁疝发生率RR=0.23,95%CI(0.14,0.36),P<0.00001]、造口脱垂发生率RR=0.38,95%CI(0.19,0.76),P=0.006]、造口出血发生率RR=0.26,95%CI(0.08,0.78),P=0.02]，但不能显著降低造口缺血发生率RR=0.45,95%CI(0.15,1.38),P=0.16]及造口水肿发生率RR=0.23,95%CI(0.00,28.52),P=0.55]。 结论：术前造口定位能有效降低肠造口患者造口相关并发症总发生率以及造口周围皮肤并发症、造口渗漏、皮肤黏膜分离、造口回缩、造口狭窄、造口旁疝、造口脱垂、造口出血发生率，但对于降低造口缺血及造口水肿发生率的证据不足。

The effect of preoperative stoma site marking on the incidence of stoma-related complications in patients with enterostomy: a meta-analysis

Objective: To evaluate the effect of preoperative stoma site marking on the incidence of stoma-related complications in patients with enterostomy, and to provide evidence for clinical practice. Methods: We searched CNKI, Wanfang Data , VIP , CBM, Pubmed, Cochrane Library, CINAHL, Embase, Ovid Emcare and British Nursing Index from the inception to June 15, 2022. After literature screening, data extraction and quality evaluation by two researchers independently, RevMan 5.3 was used for statistical analysis. Results: A total of 32 articles were included. The results of meta-analysis showed that preoperative stoma site marking can effectively reduce the overall incidence of stoma-related complications RR=0.38, 95%CI(0.28, 0.53), P <0.00001], the incidence of peristomal skin complications RR=0.47, 95%CI(0.29, 0.75), P=0.002], and the incidence of leakageRR=0.20, 95%CI(0.09,0.45), P<0.0001], the incidence of mucocutaneous separationRR=0.28, 95%CI(0.13,0.61), P=0.002], the incidence of stoma retractionRR=0.50, 95%CI(0.27,0.92), P=0.03], the incidence of stoma stenosisRR=0.27, 95%CI(0.10,0.72), P=0.009], the incidence of parastomal hernia RR=0.23, 95%CI(0.14,0.36), P<0.00001], the incidence of stoma prolapse RR=0.38, 95%CI(0.19,0.76), P=0.006] and the incidence of bleeding RR=0.26, 95%CI(0.08,0.78), P=0.02], But not significantly reduced the incidence of ischemia RR=0.45, 95%CI(0.15,1.38), P=0.16] and the incidence of edema RR=0.23, 95%CI(0.00,28.52), P=0.55]. Conclusion: Preoperative stoma site marking can effectively reduce the overall incidence of stoma-related complications and the incidence of peristomal skin complications, leakage, mucocutaneous separation, stoma retraction, stoma stenosis, parastomal hernia, stoma prolapse and bleeding. However, there is insufficient evidence to reduce the incidence of stoma ischemia and stoma edema.