多层硅泡沫敷料预防患者骶尾部及足跟部压力性损伤有效性的Meta分析

Effectiveness of multi-layer silicon foam dressing in preventing sacrococcygeal and heel pressure injury in patients:a Meta-analysis

目的通过系统评价的方法,分析多层硅泡沫敷料对预防患者骶尾部及足跟部压力性损伤的有效性。方法系统查阅中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Embase、Cochrane Library、Web of Science中关于多层硅泡沫敷料对预防住院患者骶尾部及足跟部压力性损伤有效性的随机对照研究,检索时限为2012年1月至2023年1月,由2名研究者分别筛选提取资料,对纳入研究的偏倚风险评价后,用RevMan 5.4软件进行Meta分析。结果共纳入8项随机对照研究,共4725例患者。Meta分析结果显示,多层硅泡沫敷料可以降低患者骶尾部Ⅰ期压力性损伤的发生率(RR=0.18,95%CI 0.09~0.35,P<0.01),降低患者足跟部Ⅰ期压力性损伤的发生率(RR=0.29,95%CI 0.13~0.66,P<0.05),降低患者骶尾部Ⅱ期及更严重压力性损伤的发生率(RR=0.42,95%CI 0.31~0.58,P<0.01),对足跟部Ⅱ期及更严重压力性损伤发生率的影响尚不能明确(RR=0.52,95%CI 0.27~0.99,P=0.05)。结论多层硅泡沫敷料能有效降低患者骶尾部压力性损伤的发生率,降低足跟部Ⅰ期压力性损伤的发生率,但对足跟部Ⅱ期及更严重压力性损伤发生率的影响尚不能明确。

Objective To analyze the effectiveness of multi-layer silicone foam dressing in preventing pressure injury of sacrococcygeal and heel by systematic evaluation.Methods Randomized controlled studies on the effectiveness of multi-layer silicone foam dressings in preventing stress injury of sacrococcygeal and heel of hospitalized patients in CNKI,Wanfang,VIP,CBM,PubMed,Embase,The Cochrane Library and Web of Science were systematically reviewed.The retrieval time was from January 2012 to January 2023,and the Meta were screened and extracted by two researchers respectively.After evaluating the bias risk of the included studies,they were conducted by RevMan 5.4 software.Results Eight randomized controlled studies involving 4725 patients were included.Meta-analysis showed that multilayer silicone foam dressing could reduce the incidence of sacrococcygeal stage I pressure injury(RR=0.18,95%CI 0.09-0.35,P<0.01),and reduce the incidence of the first-stage heel pressure injury(RR=0.29,95%CI 0.13-0.66,P<0.05).It could reduce the incidence of sacrococcygeal stageⅡand more serious pressure injury(RR=0.42,95%CI 0.31-0.58,P<0.01),but the influence on the incidence of the second-stage heel pressure injury and more serious heel pressure injury was not clear(RR=0.52,95%CI 0.27-0.99,P=0.05)Conclusions Multi-layer silicone foam dressing can effectively reduce the incidence of sacrococcygeal pressure injury and reduce the incidence of first-stage pressure injury in heel,but the impact on the incidence of second-stage and more serious pressure injury in heel is still unclear.