负压封闭引流不同冲洗方式对创面愈合影响的Meta分析

Meta⁃analysis of the Influence of Different Irrigation Methods of Vacuum Sealing Drainage on Wound Healing

目的系统评价负压封闭引流(VSD)不同冲洗方式对创面愈合的影响。方法检索中国期刊全文数据库(中国知网)、中文科技期刊数据库(维普)、中国学术期刊数据库(万方)、中国临床试验中心、中国生物医学文献数据库(CBM)、PubMed、ScienceDirect、Embase、The Cochrane Library等数据库建库至2022年4月27日公开发表的VSD间歇冲洗与持续冲洗治疗创面的相关文献,并根据纳入与排除标准对文献进行筛选、评价和数据提取,采用RevMan 5.3软件对纳入文献进行Meta分析。结果最终纳入符合标准文献6篇,文献质量均为B级;Meta分析结果显示,与VSD持续冲洗相比,VSD间歇冲洗更有利于提高创面愈合效果、缩短创面愈合时间及VSD平均使用时间、减轻创面疼痛(合并效应量为3.52、-3.68、-1.60、-1.85,95%CI为1.06~11.69、-5.10~-2.25、-2.09~-1.11、-2.29~-1.41,P=0.040、P<0.001、P<0.001、P<0.001),但堵管发生率较高(合并效应量为3.15,95%CI为1.24~8.01,P=0.020)。结论与VSD持续冲洗相比,VSD间歇冲洗更有利于促进创面愈合,缩短VSD平均使用时间,缓解创面疼痛,临床应用价值更高,但堵管发生风险较高。

Objective To systematically evaluate the influence of different irrigation methods of vacuum sealing drainage(VSD)on wound healing.Methods Literature search was conducted in such databases as China National Knowledge Infrastructure(CNKI),China Science and Technology Journal Database(VIP),China Science Periodical Database(Wanfang),Chinese Clinical Trial Center,Chinese Biomedical Literature Database(CBM),PubMed,Science Direct,Embase,The Cochrane Library to retrieve papers studying VSD intermittent and continuous irrigation in the treatment of wounds published between the setting-up of the databases and April 27,2022.The documents were screened out,evaluated and data extracted based on the inclusion and exclusion criteria.RevMan 53 software was applied for meta-analysis.Results A total of 6 papers screened out from the retrieved literature were included into the study,with quality evaluation of Grade B.Meta-analysis showed that,compared with the VSD continuous irrigation,the VSD intermit-tent irrigation was more favorable for improving the wound healing effect,shortening wound healing time and the mean dura-tion of VSD,and reducing wound pain(combined effect size:352,-368,-160 and-185,95%CI:106-1169,-510--225,-209--111,-229--141,P=0040,P<0001,P<0001,P<0001),but the incidence of pipeline blockage was higher(combined effect size:315,95%CI:124-801,P=0020).Conclusion Compared with the VSD continuous irrigation,the VSD intermittent irrigation is more conducive to promoting wound healing,shortening the mean duration of VSD,and alleviating wound pain,presenting much high value of clinical application,though the occur-rence risk of pipeline blockage is higher.