CAJ | 학술논문

目的评价“创面床准备”理论的实施对慢性创面的治疗效果,从而得出一个系统、规范、科学的慢性创面治疗原则.方法采用Cochrane系统评价方法,检索万方,中国期刊网(CNKI)、中国生物医学文献光盘数据库(CBM)和PubMed等电子数据库,对国内外公开发表的有关“创面床准备”理论实施的研究文献进行荟萃分析.结果共纳入65个研究、3989例各种慢性创面疾病患者.干预措施包括不同时期选择合适新型敷料、各种生长因子,清创及封闭式负压引流.按测量指标和干预措施进行亚组分析,得出结果:实施“创面床准备”理论,其创面的愈合率[0R=2.12,95％ CI( 1.79,2.52)]、愈合时间[WMD =-12.38,95％ CI(-15.14,-9.62)]、换药次数[WMD=-15.56,95％CI(-20.57,-10.56)]、需要植皮手术的例数[ 0R=0.26,95％ CI (0.10,0.66)]、缩小创面面积[WMD=8.97, 95％ CI( 1.04,16.91)]、植皮手术成功率[0R=5.69,95％CI(2.19,14.82)]均优于对照组,治疗费用[WMD=- 1.53,95％CI(-10.38,7.33)]与对照组差异无统计学意义.结论实施“创面床准备”理论指导治疗,可以提高创面的愈合率,减少创面愈合时间,加速缩小创面面积,减少换药次数,减少需要植皮手术率,提高植皮手术成功率,并且不增加治疗费用.
목적 평개“창면상준비”이론적실시대만성창면적치료효과,종이득출일개계통、규범、과학적만성창면치료원칙.방법 채용Cochrane계통평개방법,검색만방,중국기간망(CNKI)、중국생물의학문헌광반수거고(CBM)화PubMed등전자수거고,대국내외공개발표적유관“창면상준비”이론실시적연구문헌진행회췌분석.결과 공납입65개연구、3989례각충만성창면질병환자.간예조시포괄불동시기선택합괄신형부료、각충생장인자,청창급봉폐식부압인류.안측량지표화간예조시진행아조분석,득출결과:실시“창면상준비”이론,기창면적유합솔[0R=2.12,95％ CI( 1.79,2.52)]、유합시간[WMD =-12.38,95％ CI(-15.14,-9.62)]、환약차수[WMD=-15.56,95％CI(-20.57,-10.56)]、수요식피수술적례수[ 0R=0.26,95％ CI (0.10,0.66)]、축소창면면적[WMD=8.97, 95％ CI( 1.04,16.91)]、식피수술성공솔[0R=5.69,95％CI(2.19,14.82)]균우우대조조,치료비용[WMD=- 1.53,95％CI(-10.38,7.33)]여대조조차이무통계학의의.결론 실시“창면상준비”이론지도치료,가이제고창면적유합솔,감소창면유합시간,가속축소창면면적,감소환약차수,감소수요식피수술솔,제고식피수술성공솔,병차불증가치료비용.
Objective To assess the efficacy of “wound bed preparation” theory in the treatment of chronic wounds,and to provide systematic,standardized and scientific principles for treatment of chronic wounds.Methods Relevant studies on clinical use of wound bed preparation published worldwide were search in Cochrane Library,Wanfang,CNKI,CBM and PubMed databases.The quality of these studies was evaluated in meta- analysis.Results Sixty- five studies recruiting 3989 cases of chronic wound were included.The interventions at different stages included proper use of novel dressings,growth factors,debridement and negative pressure wound therapy.Meta- analysis showed that use of “wound bed preparation” theory was associated with favorable outcomes in healing rate [OR=2.12,95％ CI (1.79,2.52) ],healing time [WMD=-12.38,95％ CI ( -15.14,-9.62) ],frequency of wound dressing [WMD=-15.56,95％ CI (-20.57,-10.56) ],the need for skin-grafting [OR=0.26,95％ CI(0.I0,0.66) ],wound area reduction [ WMD=8.97,95％CI (1.04,16.91)] and successful skin-grafting [ 0R=5.69,95％ CI(2.19,14.82) ] but with comparable medical cost [WMD=-l.53,95％ CI(-10.38,7.33) ] compared with the control group.Conclusion Use of “wound bed preparation” theory may provide guidance for treatment and lead to higher healing rate,quicker wound-healing and wound area reduction,less frequent wound dressing,less need and higher success rate for skin-grafting,but not more medical expenses.