中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (18): 2941-2946.doi: 10.3969/j.issn.2095-4344.1710

• 生物材料循证医学 evidence-based medicine of biomaterials • 上一篇    下一篇

银离子敷料治疗慢性感染伤口的Meta分析

顾蓥璇1,胡  蕖1,黄林峰1,胡晓慧1,全小明2,王小俊2,王海焦2   

  1. 1广州中医药大学第一临床医学院,广东省广州市  510405;2广州中医药大学第一附属医院,广东省广州市  510405
  • 收稿日期:2019-01-22 出版日期:2019-06-28 发布日期:2019-06-28
  • 通讯作者: 全小明,教授,硕士生导师,广州中医药大学第一附属医院,广东省广州市 510405
  • 作者简介:顾蓥璇,女,1995年生,广东省普宁市人,广州中医药大学第一临床医学院在读硕士,主要从事临床护理研究。
  • 基金资助:

    广东省中医药建设专项资金立项资助科研课题(20181083),项目负责人:王海焦

Silver dressings for treating chronic infected wound: a meta-analysis

Gu Yingxuan1, Hu Qu1, Huang Linfeng1, Hu Xiaohui1, Quan Xiaoming2, Wang Xiaojun2, Wang Haijiao2    

  1. 1the First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; 2the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Received:2019-01-22 Online:2019-06-28 Published:2019-06-28
  • Contact: Quan Xiaoming, Professor, Master’s supervisor, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • About author:Gu Yingxuan, Master candidate, the First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Supported by:

    the Chinese Medicine Construction Research Project of Guangdong Province, No. 20181083 (to WHJ)

摘要:

文章快速阅读:

 

文题释义:
银离子敷料:由网格结构的羧甲基纤维素钠及1.2%的银离子组成,具有广谱抗菌特性,敷料中的银离子持续缓慢释放并与菌体蛋白表面的负电荷结合,改变菌体结构,影响遗传物质复制,杀灭细菌、真菌及其他病原体。
慢性伤口:是指由于内在和外部因素对个体和伤口的影响,伤口愈合缓慢、延迟、中断或停滞,感染是造成伤口迁延不愈的一个重要原因。
 
 
背景:银离子敷料具有良好的抗感染作用,但有关其对慢性感染伤口的治疗效果仍缺乏随机对照研究的证据。
目的:系统评价银离子敷料用于治疗慢性感染伤口的效果。
方法:应用计算机检索建库至2018年8月PubMed、Cochrane library、EMbase、Web of science、中文科技期刊全文数据库、中国期刊全文数据库、中国生物医学文献数据库、万方数据库及百度学术资源系统中,关于银离子敷料治疗慢性感染伤口的随机对照试验,经2名研究生筛选文献,提取资料与评价文献质量后,采用Revman5.3软件进行Meta分析。

结果与结论:最终纳入9篇文献,共1 268例患者,其中试验组采用银离子敷料进行治疗,对照组采用硅藻酸盐敷料、常规敷料、泡沫敷料、普通敷料、无菌纱布、凡士林纱布、灭菌纱布或聚维酮碘纱布中的一种进行治疗。Meta分析结果显示,试验组伤口愈合率高于对照组[OR=4.53,95%CI(2.87,7.15),P < 0.000 01],伤口面积减少率高于对照组[MD=8.90,95%CI(2.05,15.76),P=0.01],换药次数少于对照组[MD=-8.91,95%CI(-14.33,-3.48),P=0.001],清创时间少于对照组[MD=-8.92,95%CI(-10.03,-7.81),P < 0.000 01]。结果表明,银离子敷料能促进慢性感染伤口的愈合。

关键词: 银离子敷料, 感染伤口, 慢性感染伤口, 随机对照试验, Meta分析

Abstract:

BACKGROUND: Silver dressings have good anti-infective effect, but there is still a lack of evidence from randomized controlled studies on the efficacy of silver dressings in the treatment of chronic infected wounds.

OBJECTIVE: To systematically evaluate the efficacy of silver dressings in the treatment of chronic infected wounds.

METHODS: Databases of PubMed, Cochrane Library, EMbase, Web of science, CNKI, CBM, WanFang and Baidu Scholar were searched for the randomized controlled trials reporting the efficacy of silver dressings on chronic infected wounds published before August 2018. Literature screening, data extraction and quality assessment were conducted by two researchers, and a meta-analysis was performed on RevMan 5.3 software.
RESULTS AND CONCLUSION: Nine randomized controlled trials including 1 268 patients were enrolled. The trial group was treated with silver dressings, and the control group was treated with dialginate dressings, conventional dressings, foam dressings, general dressings, sterile gauze, vaseline gauze, sterilized gauze or povidone iodine gauze. The meta-analysis results showed that compared with the control group, the wound healing rate in the trial group was increased [OR=4.53, 95%CI (2.87, 7.15), P < 0.000 01], the rate of wound area reduction was increased [MD=8.90, 95%CI (2.05, 15.76), P=0.01], the times of dressing change was decreased [MD=-8.91, 95%CI (-14.33, -3.48), P=0.001], and the debridement time was shortened [MD=-8.92, 95%CI (-10.03, -7.81), P < 0.000 01]. To conclude, silver dressings can promote healing of chronic infected wounds.

Key words: silver dressings, infected wounds;, chronic infected wounds, randomized controlled trials, meta-analysis

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