摘要
目的 系统评价自体富血小板血浆联合负压封闭引流应用于糖尿病足溃疡的疗效。方法 通过检索中国知网、维普、万方、中国生物医学文献、PubMed、Embase、Cochrane Library、Web of Science等数据库,检索时间均为建库至2022年2月。查找所有自体富血小板联合负压封闭引流治疗糖尿病足溃疡的临床对照研究,根据纳入及排除标准进行文献筛选、质量评价和数据提取,并应用Revman Manager5.4软件进行Meta分析。结果 共纳入18篇文献,共1 403例糖尿病足溃疡患者,其中703例实验组患者行自体富血小板血浆联合负压封闭引流治疗,701例对照组行负压封闭引流或常规治疗。Meta分析结果显示:实验组有效率(RR=1.27,95%CI:1.20~1.34)、愈合率(RR=1.91,95%CI:1.67~2.18)均高于对照组,实验组愈合时间(MD=-8.75,95%CI:-10.04~-7.46)、住院时间(MD=-10.56,95%CI:-13.87~-7.24)均短于对照组,差异均有显著统计学意义(P<0.01),而住院费用(SMD=-3.21,95%CI:-6.99~0.75)比较差异无统计学意义(P>0.05);治疗后实验组患者的VEGF (SMD=1.07,95%CI:0.72~1.42)、bFGF (SMD=0.92,95%CI:0.70~1.15)表达水平均高于对照组,并发症发生率(RR=-0.13,95%CI:-0.18~-0.08)较对照组少,差异均有显著统计学意义(P<0.01)。结论 自体富血小板血浆联合负压封闭引流治疗糖尿病足溃疡疗效显著,其不仅能促进创面生长及愈合,缩短愈合及治疗时间,且不增加并发症的发生。但由于纳入文献的数量和质量,上述结论仍需高质量、大样本的前瞻性随机对照研究进一步验证。
Objective To systematically review the efficacy of autologous platelet-rich plasma combined with negative pressure sealing drainage in diabetic foot ulcers. Methods By searching CNKI, VIP, Wanfang, Chinese Biomedical Literature, PubMed, Embase, Cochrane Library, Web of Science, and other databases from inception to February2022, all clinical controlled studies of autologous platelet-rich combined with negative pressure sealing drainage in the treatment of diabetic foot ulcers were collected. Then literature screening, quality evaluation, and data extraction were carried out according to the inclusion and exclusion criteria, and Revman Manager 5.4 software was used for Meta analysis.Results A total of 18 studies were included, with a total of 1 403 patients with diabetic foot ulcers. Among them, 703 patients received autologous platelet-rich plasma combined with negative pressure sealing drainage(the experimental group), and 701 patients received negative pressure sealing drainage or conventional treatment(the control group). Meta-analysis results showed that the effective rate of the experimental group(RR=1.27, 95%CI: 1.20-1.34), the healing rate(RR=1.91, 95%CI: 1.67-2.18) were higher than those in the control group, and the healing time of the experimental group(MD=-8.75, 95% CI:-10.04 to-7.46), the length of hospital stay(MD=-10.56, 95%CI:-13.87 to-7.24) were both shorter than those in the control group, with statistically significant differences(P<0.01);there was no significant difference in hospitalization cost(SMD=-3.21, 95%CI:-6.99 to 0.75, P>0.05);VEGF(SMD=1.07, 95%CI: 0.72-1.42)and bFGF(SMD=0.92, 95%CI: 0.70-1.15) levels of the experimental group were significantly higher than those of the control group, and the incidence of complications(RR=-0.13, 95%CI:-0.18 to-0.08) was significantly lower than that of the control group;the differences were all statistically significant(P<0.01). Conclusion Autologous platelet-rich plasma combined with negative pressure closed drainage is effective in the treatment of d
作者
罗旺林
杨传军
孙伟东
史贵训
刘永安
王丹锋
LUO Wang-lin;YANG Chuan-jun;SUN Wei-dong;SHI Gui-xun;LIU Yong-an;WANG Dan-feng(Shanghai Jiading District Anting Hospital,Shanghai 201800,CHINA)
出处
《海南医学》
CAS
2023年第4期565-573,共9页
Hainan Medical Journal
基金
上海市嘉定区卫生健康委员会科研项目(编号:2021-QN-ZYY-04)。
关键词
糖尿病足溃疡
自体富血小板血浆
负压封闭引流
META分析
Diabetic foot ulcer
Autologous platelet-rich plasma
Negative pressure sealing drainage
Meta-analysis
