中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (23): 3767-3772.doi: 10.3969/j.issn.2095-4344.1261

• 组织构建循证医学 evidence-based medicine in tissue construction • 上一篇    

持续透皮氧疗法修复糖尿病足溃疡的系统评价

杨  奇,张永红,卢炎君   

  1. (山西医科大学第二临床医学院创伤骨科,山西省太原市  030001)
  • 收稿日期:2019-02-05 出版日期:2019-08-18 发布日期:2019-08-18
  • 通讯作者: 张永红,主任医师,山西医科大学第二临床医学院创伤骨科,山西省太原市 030001
  • 作者简介:杨奇,男,1993年生,山西省运城市人,汉族,山西医科大学在读硕士,医师,主要从事骨与软组织重建方面的研究。

Transdermal continuous oxygen therapy repairs diabetic foot ulcer: a systematic review 

Yang Qi, Zhang Yonghong, Lu Yanjun   

  1.  (Department of Traumatic Orthopedics, the Second Clinical Medical Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China)
  • Received:2019-02-05 Online:2019-08-18 Published:2019-08-18
  • Contact: Zhang Yonghong, Chief physician, Department of Traumatic Orthopedics, the Second Clinical Medical Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
  • About author:Yang Qi, Master candidate, Physician, Department of Traumatic Orthopedics, the Second Clinical Medical Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China

摘要:

文章快速阅读:

文题释义:

持续透皮氧疗法:该方法不同于高压氧疗和局部加压氧疗法,是指以纯净的(一般浓度为98%-100%)极低流量的氧气(3 mL/h)连续输送到伤口部位,不间断的进行治疗,其优点为设备的易用性、治疗的非侵入性且无痛。
糖尿病足溃疡:为在踝关节水平以下延伸累及全层皮肤的伤口,是糖尿病的常见、难治性并发症,其目前的标准疗法包括控制血糖水平、控制感染、减轻足部压力等,但治疗效果较差,即使采用综合治疗方案,糖尿病足溃疡12-20周的治愈率仅为24%-30%,并且可能会发生骨髓炎、蜂窝织炎、截肢等严重并发症。
摘要
背景
:持续透皮氧疗法是一种较新、无痛的治疗糖尿病足溃疡方法,现有研究对其可是否可加速糖尿病足溃疡修复的结论尚不统一,需要有系统评价总结相关结论。
目的:系统评价持续透皮氧疗法治疗糖尿病足溃疡的有效性及安全性。
方法:通过计算机对PubMed、EMBASE、Cochrane library、ClinicalKey、CNKI、万方、维普数据库进行全面的文献检索,收集比较持续透皮氧疗法(试验组)和安慰剂/空白对照(对照组)治疗糖尿病足溃疡的随机对照试验,采用RevMan 5.3软件进行Meta分析。
结果与结论:共纳入4个随机对照研究,包含311例患者。Meta分析结果显示:试验组溃疡完全愈合比例虽高于对照组,但差异无显著性意义[RR=1.73,95%CI(0.91,3.30),P=0.10];试验组不良事件发生率低于对照组[RR=0.63,95%CI(0.41,0.98),P=0.04],足部新发感染发生率低于对照组[RR=0.47,95%CI(0.26,0.85),P=0.01];结果表明,持续透皮氧疗法有利于糖尿病足溃疡周围感染的控制,且具有较高的治疗安全性,但现有证据不能证明持续透皮氧疗法可显著提高糖尿病足溃疡的愈合率。

关键词: 糖尿病足, 慢性伤口, 持续透皮氧疗法, 溃疡不愈合, 氧疗, 局部氧疗, 软组织修复, 皮肤黏膜组织构建, Meta分析, 系统评价, 随机对照研究

Abstract:

BACKGROUND: Transdermal continuous oxygen therapy is a new and painless method for treating diabetic foot ulcer. The conclusions of existing studies on whether it can accelerate the repair of diabetic foot ulcer are still not unified, and it needs systematic evaluation.
OBJECTIVE: To systematically evaluate the efficacy and safety of transdermal continuous oxygen therapy in the management of diabetic foot ulcer.
METHODS: We systematically searched PubMed, EMBASE, Cochrane library, ClinicalKey, CNKI, WanFang, and VIP databases for randomized controlled trials on assessing the efficacy of transdermal continuous oxygen therapy (trial group) and placebo/blank control (control group) in diabetic foot ulcer. Meta-analysis was conducted on RevMan 5.3 software.
RESULTS AND CONCLUSION: Four randomized controlled trials involving 311 patients were included. The meta-analysis results suggested that the proportion of complete ulcer healing in the trial group was higher than that in the control group, but the difference was insignificant [RR=1.73, 95%CI (0.91, 3.30), P=0.10]. The incidence of adverse events [RR=0.63, 95%CI (0.41, 0.98), P=0.04] and the incidence of new foot infection [RR=0.47, 95%CI (0.26, 0.85), P=0.01] in the trial group were lower than those in the control group. These results indicate that transdermal continuous oxygen therapy has high safety and can reduce the incidence of infection to some extent, but the current evidence does not show that it can obviously increase the healing rate of diabetic foot ulcer.

Key words: diabetic foot, chronic wound, transdermal continuous oxygen therapy, non-healing ulcer, oxygen therapy, topical oxygen therapy, soft tissue repair, construction of skin and mucosa tissue, meta-analysis, systematic review, randomized controlled trial

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