自体富血小板血浆治疗藏毛窦术后创面临床疗效的Meta分析

Meta-analysis of the Clinical Efficacy of Autologous Platelet-rich Plasma in Treating Pilonidal Sinus Postoperative Wounds

目的系统评价自体富血小板血浆(aPRP)治疗藏毛窦(PS)术后创面的应用效果。方法检索PubMed、Emabse、Cochrane Library、Web of Science、中国期刊全文数据库(中国知网)、中国生物医学文献数据库、中国学术期刊数据库(万方)、中文科技期刊数据库(维普)等数据库自建库至2022年9月公开发表的aPRP治疗PS术后创面的中英文临床随机对照试验文献,根据纳入与排除标准筛选文献后进行质量评价,并使用RevMan 5.4软件对纳入文献进行统计分析。结果共纳入文献7篇,包括615例PS患者。Meta分析结果显示,与常规敷料包扎处理相比,在常规敷料包扎基础上联合应用aPRP更能有效缩短PS术后创面愈合时间、疼痛持续时间及患者回归正常生活及工作时间,降低术后创面视觉模拟评分法(VAS)评分(MD=-16.37、-9.45、-8.91、-3.19,95%CI为-24.55~-8.19、-15.60~-3.31、-9.44~-8.38、-5.04~-1.34,P<0.0001、P=0.003、P<0.00001、P=0.0007),但在降低创面感染率及复发率方面无明显差异(RR=0.75、0.60,95%CI为0.21~2.72、0.15~2.42,P=0.66、0.47)。结论在常规敷料包扎基础上联合应用aPRP能有效缩短PS术后创面愈合时间、疼痛持续时间及患者回归正常生活及工作时间,降低术后疼痛程度。

Objective To systematically evaluate the clinical efficacy of autologous platelet-rich plasma(aPRP)in treating pilonidal sinus(PS)postoperative wounds.Methods Literature search was conducted in such databases as PubMed,Emabse,Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Chinese Biomedical Literature Database,China Science Periodical Database(Wanfang),China Science and Technology Journal Database(VIP)to retrieve Chinese and English clinical randomized controlled trials studying aPRP in the treatment of PS postoperative wounds published between the setting-up of the databases and September 2022,the obtained papers were evaluated based on the inclusion and exclusion criteria,and qualified papers were analyzed statistically by using the RevMan 5.4 software.Results A total of 7 papers were qualified and included into the study,with 615 PS patients involved.Meta-analysis showed that,compared with the conventional dressing and bandaging treatment,the combined application of aPRP and the conventional dressing and bandaging treatment was more effective in shortening the healing time of PS postoperative wounds,the duration of patients’pain,and time of patients back to normal life and work,and reducing post-operative wound visual analogue scale(VAS)scores of patients(MD=-16.37,-9.45,-8.91 and-3.19,95%CI:-24.55--8.19,-15.60--3.31,-9.44--8.38,-5.04--1.34,P<0.0001,P=0.003,P<0.00001,P=0.0007),but there was no significant difference in reducing wound infection and recurrence rates(RR=0.75 and 0.60,95%CI:0.21-2.72,0.15-2.42,P=0.66 and 0.47).Conclusion The combined application of aPRP and conventional dressing and bandaging treatment can effectively shorten the PS postoperative wound healing time,pain duration,and time of patients back to normal life and work,and alleviate the degree of postoperative pain.