封闭式负压引流联合高压氧治疗慢性难愈性创面的系统评价

A systematic review and meta-analysis of closed negative pressure drainage combined with hyperbaric oxygen in the treatment of chronic nonhealing wounds

目的对封闭式负压引流技术联合高压氧治疗慢性难愈性创面的临床疗效和安全性进行系统评价。方法检索Embase、Pub Med、Cochrane Library、Web of Science、中国知网(CNKI)和万方数据库等数据库,检索时间为建库至2020年12月28日。根据纳入标准及排除标准筛选文献,参考Cochrane手册和NOS量表进行文献质量评价,使用R语言Meta数据包对纳入的文献进行Meta分析。结果共纳入10篇文献,其中包含随机临床对照试验5篇和回顾性研究5篇,共计591例患者,其中治疗组294例,对照组297例。Meta分析结果:治疗组(封闭式负压引流联合高压氧)在创面愈合率、创面愈合时间、创面面积等方面均优于对照组(封闭式负压引流),差异有统计学意义(P<0.05)。结论封闭式负压引流联合高压氧较单纯负压引流治疗,在难愈性创面治疗方面具有较高的优势,但该结论还需要较大样本和更高质量的随机临床对照试验进一步验证。

Objective To evaluate the clinical efficacy and safety of closed negative pressure drainage combined with hyperbaric oxygen in the treatment of chronic nonhealing wounds.Methods The Embase,Pub Med,Cochrane Library,Web of Science,CNKI and Wanfang database were searched from establishment of database to 28 th December 2020.The literatures were screened according to the inclusion criteria and exclusion criteria,and the literature quality was evaluated with reference to Cochrane manual and NOS scale.The included literatures were analyzed by meta with the R Project meta package.Results A total of 10 literatures were included,including5 randomized controlled trials and 5 retrospective studies,with a total of 591 patients,including 294 patients in the treatment group and297 patients in the control group.The results of meta analysis showed that the wound healing rate,wound healing time and wound area in the treatment group(closed negative pressure drainage combined with hyperbaric oxygen)were better than those in the control group(closed negative pressure drainage alone),and the difference was statistically significant(P<0.05).Conclusion Closed negative pressure drainage combined with hyperbaric oxygen has more advantages than closed negative pressure drainage alone in the treatment of nonhealing wounds,but this conclusion need to be further verified by larger samples and higher quality randomized clinical controlled trials.