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一项关于真空密封引流联合自体富血小板血浆治疗 2 级和 3 级糖尿病足溃疡疗效的荟萃分析。

A meta-analysis on the efficacy of vacuum sealing drainage combined with autologous platelet-rich plasma in the treatment of Grade 2 and Grade 3 diabetic foot ulcers.

机构信息

Department of Endocrinology, The First Hospital of Nanchang (The Third Affiliated Hospital of Nanchang University), Nanchang, Jiangxi, China.

Department of Biochemistry, Medical College of Georgia, Augusta, Georgia, USA.

出版信息

Int Wound J. 2023 Apr;20(4):1033-1041. doi: 10.1111/iwj.13956. Epub 2022 Sep 16.

Abstract

This meta-analysis aims to systemically evaluate the efficacy of vacuum sealing drainage (VSD) combined with autologous platelet-rich plasma (PRP) in the treatment of diabetic foot ulcers (DFU). The China HowNet, China Biomedical Literature, VIP periodical resource integration service platform, Wanfang, Embase, Cochrane Central, and PubMed databases were retrieved using the computer. The retrieval period was up to July 2021. Randomised controlled trials on VSD combined with PRP in the treatment of DFU were collected. Those trials that met the inclusion criteria were included for meta-analysis using RevMan 5.3 software. A total of 13 articles were included. In the trial group, 477 patients with DFU were treated with VSD combined with PRP, while in the control group, 482 patients with DFU were treated with conventional dressings and/or VSD. The meta-analysis showed that, compared with the control group, VSD combined with PRP has significant advantages in shortening healing time (standardised mean difference [SMD] = -0.87, 95% confidence interval [CI]: -1.07 to -0.67, P < .00001), improving ulcer healing rates (odds ratio = 4.01, 95% CI: 2.95 ~ 5.46, P < .00001), and reducing hospital stays (mean difference = -15.29, 95% CI: -16.05 to -14.54, P < .00001), but the differences in dressing change times (SMD = -1.27, 95% CI: -2.71 to 0.17, P = .08) and hospitalisation expenses (SMD = -0.16, 95% CI: -13.40 to 13.07, P = .98) were not statistically significant. VSD combined with autologous PRP has good curative efficacy in the treatment of DFU and is a better treatment option. However, this treatment is limited in patients with platelet dysfunction, thrombocytopenia, leukaemia, and poor general condition.

摘要

本荟萃分析旨在系统评估真空密封引流(VSD)联合富血小板血浆(PRP)治疗糖尿病足溃疡(DFU)的疗效。使用计算机检索中国知网、中国生物医学文献、维普期刊资源整合服务平台、万方、Embase、Cochrane 中心和 PubMed 数据库。检索期限截至 2021 年 7 月。收集 VSD 联合 PRP 治疗 DFU 的随机对照试验。符合纳入标准的试验采用 RevMan 5.3 软件进行荟萃分析。共纳入 13 篇文章。在试验组中,477 例 DFU 患者采用 VSD 联合 PRP 治疗,而在对照组中,482 例 DFU 患者采用常规敷料和/或 VSD 治疗。荟萃分析结果显示,与对照组相比,VSD 联合 PRP 在缩短愈合时间(标准化均数差 [SMD] =-0.87,95%置信区间 [CI]:-1.07 至-0.67,P < .00001)、提高溃疡愈合率(优势比 [OR] =4.01,95% CI:2.95 至 5.46,P < .00001)和减少住院时间(均数差 [MD] =-15.29,95% CI:-16.05 至-14.54,P < .00001)方面有显著优势,但在更换敷料次数(SMD =-1.27,95% CI:-2.71 至 0.17,P =0.08)和住院费用(SMD =-0.16,95% CI:-13.40 至 13.07,P =0.98)方面差异无统计学意义。VSD 联合自体 PRP 治疗 DFU 具有良好的疗效,是一种较好的治疗选择。然而,这种治疗方法在血小板功能障碍、血小板减少症、白血病和一般状况较差的患者中受到限制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5b3/10031232/a428f3e0a7aa/IWJ-20-1033-g005.jpg

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