摘要
目的系统评价负压封闭引流术(VSD)治疗糖尿病足溃疡的疗效及安全性。方法检索中国知网、中国生物医学文献数据库、维普、万方及Embase、Cochrane Central、PubMed数据库,检索时间为2000年1月至2019年5月。收集采用VSD治疗糖尿病足溃疡的随机对照试验研究,对符合纳入标准的研究采用RevMan 5.3软件进行Meta分析。结果共纳入10篇文献,包括440例采用VSD治疗的糖尿病足溃疡患者和442例采用常规换药治疗的糖尿病足溃疡患者。Meta分析结果显示,与常规换药相比,VSD疗法在提高伤口完全愈合率(OR=2.29,95%CI 1.66~3.15,P<0.00001)、降低二次截肢率(OR=0.29,95%CI 0.14~0.61,P=0.001)、缩短伤口愈合时间(MD=-2.47,95%CI-3.40^-1.54,P<0.00001)及换药次数(MD=-34.29,95%CI-56.18^-12.41,P=0.002)方面具有显著优势,但在降低并发症发生率方面两种方法差异无统计学意义(OR=1.10,95%CI 0.67~1.78,P=0.71)。结论VSD治疗糖尿病足溃疡效果较常规换药更显著,为更优治疗方案。
Objective To assess the efficacy and adverse events of vacuum sealing drainage(VSD)in the treatment of diabetic foot ulcers.Methods Databases such as PubMed,Cochrane Central,Embase,CNKI,CBMdisc,VIP and WanFang were searched from Jan.2000 to May 2019,and randomized controlled trials of VSD in the treatment of diabetic foot ulcers were collected.For all the included studies,we performed Meta-analysis using RevMan 5.3.Results Altogether 10 literatures were included involving 440 cases which received VSD and 442 cases which received standard dressing changes.Meta-analysis revealed these outcomes:compared with the standard dressing changes,VSD had a higher rate of complete healing of ulcers(OR=2.29,95%CI 1.66-3.15,P<0.00001),lower rate of secondary amputation(OR=0.29,95%CI 0.14-0.61,P=0.001),shorter healing time(MD=-2.47,95%CI-3.40--1.54,P<0.00001),and less dressing changes(MD=-34.29,95%CI-56.18--12.41,P=0.002),but there was no significant difference in the incidence of adverse effects(OR=1.10,95%CI 0.67-1.78,P=0.71).Conclusion VSD is more effective than standard dressing changes treatment for diabetic foot ulcers,and is a better treatment plan.
作者
刘楚贤
陈世玖
LIU Chuxian;CHEN Shijiu(Department of Burn and Plastic Surgery,the Fifth Affiliated(Zhuhai)Hospital of Zunyi Medical University,Zhuhai 519100,China)
出处
《医学综述》
2020年第18期3723-3728,共6页
Medical Recapitulate
