充气加压治疗对下肢静脉性溃疡患者伤口愈合效果的Meta分析

The effectiveness of compression therapy with pneumatic compression devices on wound healing in patients with venous ulcers:a meta analysis

目的比较充气加压治疗与短延展绷带压力治疗对下肢静脉性溃疡患者伤口愈合的影响。方法计算机检索Cochrane Library、PubMed、CINAHL、Web of Science、中国知网、万方、维普、中国生物医学文献数据库中关于充气加压治疗与短延展绷带压力治疗对下肢静脉性溃疡患者伤口愈合效果的随机对照试验。检索时限为建库至2021年1月20日。2名研究者独立按照纳入与排除标准筛选文献、提取资料和评价方法学质量后,采用RevMan 5.3软件进行Meta分析。结果最终纳入6篇随机对照试验,共350例患者。Meta分析结果显示,充气加压治疗与短延展绷带压力治疗对下肢静脉性溃疡患者伤口愈合率[RR=0.88,95%CI(0.71,1.09),P=0.25]、伤口面积变化[MD=-3.22,95%CI(-6.73,0.28),P=0.07]、伤口愈合速度[SMD=1.45,95%CI (-0.31,3.21),P=0.11]、不良事件发生率[RR=0.55,95%CI(0.08,3.75),P=0.54]的影响,差异无统计学意义(P>0.05)。结论充气加压治疗对下肢静脉性溃疡患者伤口愈合率、伤口面积变化、伤口愈合速度以及不良事件发生率的影响与短延展绷带压力治疗效果相近。本研究纳入的文献均来自国外,未来可在国内开展相关研究,进一步明确下肢静脉性溃疡患者进行充气加压治疗的可行性和适宜性。

Objective To evaluate the effect of pneumatic compression devices and short stretch bandages com-pression therapy on wound healing in patients with leg venous ulcer. Methods Databases such as the Cochrane Library,PubMed,CINAHL,Web of Science,CNKI,Wanfang,VIP and CBM database were searched up to January20,2021 for randomized controlled trials(RCTs) on the effectiveness of pneumatic compression devices and short stretch bandages compression therapy on wound healing in patients with venous ulcers. According to the inclusion and exclusion criteria,2 researches independently screened each database,extracted data,and assessed the methodological quality of included studies. RevMan 5.3 software was used for meta analysis. Results 6 RCT studies involving 350 patients were included. The meta analysis showed that there was no significant difference of the pneumatic compression devices compared with the short stretch bandage for compression therapy in wound healing rate[RR=0.88,95%CI(0.71,1.09),P=0.25],change of ulcer size[MD=-3.22,95%CI(-6.73,0.28),P=0.07],rate of healing[SMD=1.45,95%CI(-0.31,3.21),P=0.11],and adverse event [RR=0.55,95%CI(0.08,3.75),P=0.54]. Conclusion Compression therapy for leg venous ulcer patients with pneumatic compression devices can achieve similar effects with short stretch bandage on wound healing rate,change of ulcer size,rate of healing,and adverse event. As all the studies included in this meta-analysis are foreign literature,pilot trials with small samples can be carried out in the future to further evaluate the applicability and feasibility of pneumatic compression therapy in leg venous ulcer patient in China.