<br>不同口腔手术后的菌血症：系统评价和荟萃分析,Oral Diseases

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不同口腔手术后的菌血症：系统评价和荟萃分析
Oral Diseases ( IF 2.9 ) Pub Date : 2023-02-07 , DOI: 10.1111/odi.14531
Carolina C Martins ₁ , Peter B Lockhart ₂ , Ramon T Firmino _{1,

3} , Catherine Kilmartin ₄ , Thomas J Cahill ₅ , Mark Dayer ₆ , Ingrid G P Occhi-Alexandre _{1,

7} , Honghao Lai ₈ , Long Ge ₈ , Martin H Thornhill _{2,

9}

Affiliation

评估侵入性牙科手术 (IDP) 或日常生活活动 (ADL) 后菌血症的发生时间、持续时间和发生率。检索了八个数据库中评估健康个体 IDP 或 ADL 前后菌血症的随机 (RCT) 和非随机对照试验 (nRCT)。通过 RoB 2.0 和 ROBINS-I 评估偏倚风险。对于荟萃分析，主要结果是菌血症的时间和持续时间。次要结果是菌血症的发生率，测量手术结束后 5 分钟内与基线相比出现菌血症的患者比例。我们纳入了 64 项 nRCT 和 25 项 RCT。术后 5 分钟内出现菌血症高峰，然后随着时间的推移而下降。拔牙显示菌血症发生率最高（62%–66%），其次是洗牙和根面平整术（SRP）（44%–36%）和口腔保健程序（OHP）（例如，不使用SRP的牙科预防和牙科探诊）（27%–28%）。其他 ADL（使用牙线和咀嚼）（16%）和刷牙（8%–26%）也会导致菌血症。大多数研究都关注随机对照试验或中等偏倚风险的随机对照试验。拔牙、SRP 和 OHP 与菌血症发生率最高有关。刷牙、使用牙线和咀嚼也会引起菌血症，但发生频率较低。

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Bacteremia following different oral procedures: Systematic review and meta-analysis

To evaluate the timing, duration and incidence of bacteremia following invasive dental procedures (IDPs) or activities of daily living (ADL). Eight databases were searched for randomized (RCTs) and nonrandomized controlled trials (nRCTs) evaluating bacteremia before and after IDPs or ADL in healthy individuals. The risk of bias was assessed by RoB 2.0 and ROBINS-I. For the meta-analysis, the primary outcomes were the timing and duration of bacteremia. The secondary outcome was the incidence of bacteremia, measuring the proportion of patients with bacteremia within 5 min after the end of the procedure compared with baseline. We included 64 nRCTs and 25 RCTs. Peak bacteremia occurred within 5 min after the procedure and then decreased over time. Dental extractions showed the highest incidence of bacteremia (62%–66%), followed by scaling and root planing (SRP) (44%–36%) and oral health procedures (OHP) (e.g., dental prophylaxis and dental probing without SRP) (27%–28%). Other ADL (flossing and chewing) (16%) and toothbrushing (8%–26%) resulted in bacteremia as well. The majority of studies had some concerns RCTs or moderate risk of bias nRCTs. Dental extractions, SRP and OHP, are associated with the highest frequency of bacteremia. Toothbrushing, flossing, and chewing also caused bacteremia in lower frequency.

更新日期：2023-02-07

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