聚乙烯薄膜覆盖眼睑预防暴露性角膜损伤效果的Meta分析

Effect of polyethylene membrane to cover eyelid on preventing exposure corneal injury：Meta analysis

目的：评价聚乙烯薄膜覆盖眼部预防危重患者角膜损伤的效果。方法计算机检索Cochrane Library、JBI、MEDLINE、Nursing Consult、EMbase、PubMed、中国生物医学文献服务系统（ CBM）、中国期刊全文数据库（ CNKI）,以及万方数据资源系统中关于聚乙烯薄膜覆盖眼部用于预防瞬目反射减弱或消失患者暴露性角膜炎的随机对照试验、类实验性研究,同时筛检纳入文献的参考文献。由2名研究者对文献质量进行严格评价和资料提取,对符合质量标准的研究进行Meta分析。结果共纳入5篇RCT及1篇类实验性研究,共607例患者。 Meta分析结果显示,聚乙烯薄膜覆盖眼部法相对于滴眼液法能够有效减少角膜损伤的发生[OR=0.08,95%CI（0.02,0.35）,P〈0.01],与润滑眼膏法对降低角膜损伤发生率的作用无差别[OR=0.56,95%CI（0.06,5.53）,P〉0.05],聚乙烯薄膜覆盖眼部法总体相对于其他方法来说能更有效降低角膜损伤发生率[OR=0.26,95%CI（0.13,0.52）,P〈0.01]。结论聚乙烯薄膜覆盖眼部应用于瞬目反射减少或消失的患者有助于降低角膜损伤的发生率,且简便易行,更具经济效益,因此值得在临床推广。

Objective To assess the application of polyethylene membrane to cover eyelid on preventing exposure corneal injury. Methods We utilized computer to search randomized controlled trail （RCT） and experimental study of Cochrane Library, JBI, MEDLINE, Nursing Consult, EMbase, Pubmed, CBM, CNKI and Wanfang database for the literatures about using polyethylene membrane to cover eyelid for preventing corneal damage. Then two researchers screened the literatures at the same time, assessed the quality and extract the data, and finally took meta-analysis for the literatures which were qualified. Results A total of 5 RCTs and 1 CCT, 607 patients in all were involved into our research. The results of Meta-analysis suggested that using polyethylene membrane could reduce the probability of corneal damage more than using eye drops [OR=0. 08, 95%CI（0. 02, 0. 35）,P〈0. 01], and had the same effect on reducing corneal damage as using lubricant [OR=0. 56, 95%CI（0. 06, 5. 53）,P〉0. 05]. Generally polyethylene membrane had better effects on reducing the probability of corneal damage than other methods [OR=O. 26, 95%CI （0. 13, 0. 52）,P〈0. 01]. Conclusions The application of polyethylene membrane to cover eyelid can reduce the probability of corneal damage and blink reflex effectively. This method is simple, practical, and economized, so we should spread it on clinic.