五种常用敷料治疗静脉炎效果的网状Meta分析

Effects of five different dressings in the treatment of phlebitis：a network Meta-analysis

目的：采用网状Meta分析的方法评价5种常用敷料治疗静脉炎的效果。方法检索PubMed、Embase、Cochrane Library、Web of Science、CINAHL、中国生物医学文献数据库（CBM）、中国知网（CNKI）及万方数据期刊论文资源等中外文数据库，检索时间截至2016年1月，纳入对比敷料治疗静脉炎的随机对照试验（RCT）。采用Cochrane系统评价手册5.1.0版提供的偏倚风险评估工具对纳入RCT进行质量评价。2名研究者独立进行数据提取和质量评价，采用WinBugs、R、Stata软件进行数据处理。结果最终纳入27个RCT，共2283例患者。网状Meta分析结果显示，水胶体敷料、泡沫敷料、凝胶敷料以及薄膜敷料治疗静脉炎的效果均优于50%硫酸镁湿敷（P＜0.05）；而不同类型敷料间在静脉炎治愈率的差异均无统计学意义（P＞0.05）。根据累积排序概率曲线下面积（SUCRA）结果，薄膜敷料、水胶体敷料是治疗静脉炎的较优方案。结论基于网状Meta分析结果和SUCRA排序结果，薄膜敷料和水胶体敷料治疗静脉炎效果优于其他敷料；未来研究应关注不同类型敷料间效果的直接比较及成本效益分析。

Objective To evaluate the effects of five different dressings in the treatment of phlebitis. Methods A systematic search of PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, Chinese Biomedical Literature Database (CBM), Chinese Knowledge Infrastructure (CNKI) and WanFang Database was carried out. Randomized control trials (RCTs) examining the effects of dressings for the treatment of phlebitis were included. Methodological quality of included RCTs was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. All data was screened, extracted and reviewed by 2 researchers independently and analyzed by WinBugs, R and Stata. Results 27 RCTs involving 2 283 patients were included. The results of network Meta-analysis showed the statistically significant difference in favor of hydrocolloid, foam, hydrogels and film dressings when compared to 50% magnesium sulfate (P<0.05). However, there was no difference in effects between different dressings on the treatment of phlebitis (P>0.05). Probability ranking according to surface under the cumulative ranking possibility for film and hydrocolloid dressings in the treatment of phlebitis. Conclusions Based on the results of network Meta-analysis and rank, film and hydrocolloid dressings were superior to other dressings in the treatment of phlebitis. More attentions should be made regarding comparisons directly of different dressing and reporting of cost-effective analysis.