Meta-analysis of influencing factors of parastomal hernia in adult patients undergoing ostomy
10.3760/cma.j.cn115682-20191213-04581
- VernacularTitle:成人造口患者发生造口旁疝影响因素的Meta分析
- Author:
Yingying XU
1
;
Bei ZHU
;
Lei YAN
;
Qing WEI
;
Shengzhi CHEN
Author Information
1. 江苏大学医学院护理系，镇江 212001
- Keywords:
Adult;
Parastomal hernia;
Risk factors;
Meta-analysis
- From:
Chinese Journal of Modern Nursing
2020;26(17):2327-2332
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the influencing factors of parastomal hernia in patients undergoing ostomy, and provide a scientific basis for the early prevention of parastomal hernia.Methods:Articles concerning the influencing factors of parastomal hernia in patients undergoing ostomy which were published up to June 2019 were retrieved from PubMed, Embase, Web of Science, ScienceDirect, China National Knowledge Infrastructure (CNKI) , Wanfang, VIP and Chinese Biomedical Literature Database (CBM) . RevMan 5.3 was used to conduct a Meta-analysis on 13 research results, and a fixed effect model and a random effect model were employed to calculate the combined OR value and 95% confidence interval ( CI) . Results:A total of 13 articles were included, involving totally 1 857 cases in the case group and 5 888 cases in the control group. The Meta-analysis of various factors combined with OR or weighted mean difference ( WMD) and 95% CI were BMI ( OR=2.29, 95% CI 2.00-2.57) , female ( OR=1.45, 95% CI 1.19-1.76) , extraperitoneal ostomy ( OR=0.22, 95% CI 0.11-0.41) , chronic obstructive pulmonary disease (COPD) or chronic cough ( OR=1.82, 95% CI 1.21-2.73) , hypertension ( OR=2.46, 95% CI 1.45-4.15) , laparoscopic surgery ( OR=1.39, 95% CI 1.30-1.50) , stoma infection ( OR=2.11, 95% CI 1.26-3.53) . Conclusions:Based on the available evidence, the risk factors for parastomal hernia in patients undergoing ostomy include high BMI, female, COPD or chronic cough, hypertension, laparoscopic surgery and stoma infection, while extraperitoneal ostomy is a protective factor for parastomal hernia. Smoking, diabetes, preoperative radiotherapy / chemotherapy and previous history of abdominal surgery is not associated with the occurrence of parastomal hernia. Stoma size, hypoproteinemia, rectus abdominis stoma, previous history of hernia repair and the use of steroids need to be further verified through more studies. Medical staff should pay attention to these influencing factors, take pertinent measures to prevent them, and improve the quality of nursing services.
