五种常用敷料治疗压疮疗效的网状Meta分析

Network Meta-analysis of five common dressings in the treatment of pressure ulcer

背景:目前压疮治疗外用敷料品种繁多,挑选一种使用方便、安全、有效的敷料,可有效提高压疮治愈率。目的:系统评价5种敷料治疗压疮的效果。方法:应用计算机检索Embase、PubMed、Elsevier、维普数据库、万方数据库、中国知网数据库中关于不同敷料治疗压疮的随机对照试验,检索时间从建库至2018年7月,检索关键词为"pressure sore、pressure ulcer、decubitusulcer、bedsore、dressing、bandage、randomizedclincaltrails、压疮、压力性溃疡、压力性损伤、敷料、贴敷、绷带"。由2名研究人员分别进行文献筛选、资料提取及质量评价,用ADDIS 1.16.8软件进行网状Meta分析。结果与结论:最终纳入24个随机对照试验,共1201例患者,涉及水胶体敷料、泡沫敷料、水凝胶敷料、凡士林纱布、无菌纱布5种敷料。网状Meta分析结果显示,水胶体敷料、泡沫敷料治疗压疮的效果优于无菌纱布、凡士林纱布(P<0.05),其余敷料两两比较治疗效果无差异(P>0.05)。根据排序概率表得知,5种敷料治疗压疮效果的排序依次为:水胶体敷料、泡沫敷料、水凝胶敷料、无菌纱布、凡士林纱布。结果表明,水胶体敷料、泡沫敷料治疗压疮的效果优于其他敷料。

BACKGROUND: There are many kinds of dressings for external use in treating pressure ulcer. Selecting a kind of dressing which is convenient, safe and effective can effectively increase the healing rate of pressure ulcer. OBJECTIVE: To evaluate the effects of five common dressings on the treatment of pressure ulcer. METHODS: A systematic search of Embase, PubMed, VIP, Elsevier, WanFang and CNKI were carried out with an end-point of July 2018. Randomized controlled trials about the therapeutic effects of different dressings on pressure ulcer were collected. All data were screened, extracted and assessed by two researchers independently. The ADDIS 1.16.8 software was adopted for data an alysis. RESULTS AND CONCLUSION: A total of 24 randomized control trials(1201 patients) which involved 5 kinds of dressings were included. The results of network Meta-analysis showed that the effect of hydrocolloid dressing and foam dressing were superior to aseptic gauze and vaseline gauze in treating pressure ulcer(P < 0.05). There was no difference in the therapeutic effect between the resting dressings(P > 0.05). Based on the probability ranking table, the therapeutic effects of five kinds of dressings in pressure ulcer were ranked as follows: hydrocolloid dressing > foam dressing > hydrogel dressing > sterile gauze > vaseline gauze. Hydrocolloid dressing and foam dressing were s uperior to the other dressings in the treatment of pressure ulcer.