自体富血小板血浆联合负压封闭引流技术治疗慢性难愈性创面疗效的Meta分析

Effects of autologous platelet-rich plasma combined with negative pressure wound therapy for chronic refractory wounds:a Meta-analysis

目的系统性评价自体富血小板血浆联合负压封闭引流技术对慢性难愈性创面的治疗效果,为其临床治疗提供参考依据。方法检索知网、万方、维普、PubMed、Embase、Cochrane Library等数据库,检索时间从建库起止至2022年11月,纳入符合要求的自体富血小板血浆联合负压封闭引流技术治疗慢性难愈性创面的随机对照试验,通过文献筛选、数据提取、质量评价后,采用Stata 15.1软件进行Meta分析。结果经过筛选,共检索出11篇中文文献符合本文标准,共计359例慢性难愈性创面患者病例,观察组均采用自体富血小板血浆联合负压封闭引流技术治疗,对照组单独采用负压封闭引流技术治疗。Meta分析提示,与负压封闭引流技术单独治疗相比,自体富血小板血浆联合负压封闭引流技术治疗的创面愈合时间缩短[WMD=-6.08,95%CI(-7.77,-4.40),P<0.05],住院治疗时间缩短[WMD=-8.24,95%CI(-11.55,-4.94),P<0.05],疼痛评分降低[WMD=-1.73,95%CI(-2.06,-1.40),P<0.05],创面细菌培养阳性率降低[RR=0.28,95%CI(0.16,0.49),P<0.05],创面治疗效果较好[RR=1.28,95%CI(1.17,1.41),P<0.05]。结论基于目前的研究,与负压封闭引流技术单独治疗相比,自体富血小板血浆联合负压封闭引流技术更能有效促进慢性难愈性创面愈合,缩短住院时间同时减轻疼痛,减少感染,临床治疗效果较好。

Objective To systematically evaluate the therapeutic efficacy of autologous platelet-rich plasma combined with negative pressure wound therapy on chronic refractory wounds,and to provide reference for clinical treatment.Methods Randomized controlled trials of autologous platelet-rich plasma combined with negative pressure wound therapy for the treatment of chronic refractory wounds were included in the databases of CNKI,Wan fang,VIP,PubMed,Embase and Cochrane Library from the time of database construction to November 2022.After literature screening,data extraction and quality evaluation,Meta analysis was performed using Stata 15.1 software.Results After screening,a total of 11 Chinese literatures that met the criteria of this paper were retrieved,involving a total of 359 patients with chronic refractory wounds.The observation group was treated with autologous platelet-rich plasma combined with negative pressure wound therapy,and the control group was treated with negative pressure wound therapy alone.Meta-analysis suggested that compared with negative pressure wound therapy alone,autologous platelet-rich plasma combined with negative pressure wound therapy shortened wound healing time[WMD=-6.08,95%CI(-7.77,-4.40),P<0.05].The hospitalization was shortened[WMD=-8.24,95%CI(-11.55,-4.94),P<0.05],the pain score was decreased[WMD=-1.73,95%CI(-2.06,-1.40),P<0.05],and the positive rate of bacterial culture on the wound was decreased[RR=0.28,95%CI(0.16,0.49),P<0.05],the wound treatment effect was good[RR=1.28,95%CI(1.17,1.41),P<0.05].Conclusion Based on current studies,compared with the negative pressure wound therapy alone,autologous platelet-rich plasma combined with negative pressure wound therapy can effectively promote the healing of chronic refractory wounds,shorten the hospital stay,reduce pain and infection,and the clinical treatment effect is better.