下肢静脉溃疡病人负压伤口治疗的最佳证据总结

Summary of the best evidence for negative pressure wound therapy in patients with venous ulcer of the lower extremities

目的:检索下肢静脉溃疡负压伤口治疗的相关证据,为临床规范应用负压伤口治疗下肢静脉溃疡提供参考。方法:按照6S模型自上而下的原则,系统检索国内外数据库中关于下肢静脉溃疡病人负压伤口治疗的相关证据,包括临床决策、指南、系统评价、随机对照试验及专家共识,检索时限为建库至2022年9月。结果:共纳入9篇文献,其中指南1篇、临床决策1篇、系统评价1篇、随机对照试验2篇和专家共识4篇,包括应用时机、负压模式选择、负压值设定、负压材料选择、负压效果评价及疼痛管理6个方面共16条证据。结论:医护人员应将创面的特点、科室临床环境与病人意愿相结合,恰当地运用证据,以规范负压伤口治疗在下肢静脉溃疡中的应用。

Objective:To search the evidence of negative pressure wound therapy of lower extremity venous ulcer,and to provide reference for clinical standard application of negative pressure wound therapy in the treatment of lower extremity venous ulcer.Methods:According to the top-down principle of 6S model,relevant evidence on negative pressure wound therapy for patients with venous ulcer of lower extremity was systematically searched from domestic and foreign databases,including clinical decisions-making,guidelines,systematic reviews,randomized controlled trials and expert consensuses.The search time was from the establishment of the databases to April 2022.Results:A total of 9 papers were included,including one guideline,one clinical decision,one systematic evaluation,two randomized controlled trials and four expert consensus,there were 16 pieces of evidence from 6 aspects,including application timing,negative pressure mode selection,negative pressure value setting,negative pressure material selection,negative pressure effect evaluation and pain management.Conclusion:Medical staff should combine the characteristics of the wound,the clinical environment of the department and the patient′s wishes,and properly use the evidence to standardize the application of negative pressure wound treatment in venous ulcers of lower extremities.