硅凝胶膜治疗病理性瘢痕的系统评价  

Silicon gel sheeting for pathological scars:A systematic review

作　　者：宋黎[1] 熊琳[1] 吴泰相[2] 

机构地区：[1]四川大学华西医院皮肤性病科,四川省成都市610041 [2]四川大学华西医院循证医学中心,四川省成都市610041

出　　处：《中国组织工程研究与临床康复》2009年第42期8233-8236,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:评价硅凝胶膜治疗病理性瘢痕的有效性及安全性。资料来源:计算机检索Cochrane图书馆临床对照试验数据库(Cochrane Central Register of Controlled Trials,2009年第3期)、MEDLINE光盘数据库(1966/2009-09)、EMBASE光盘数据库(1984/2009-09)、中国生物医学文献数据库(CBM,1979/2009-09)、维普中文数据库(VIP,1989/2009-09)、中国期刊全文数据库(CNKI,1979/2009-09)及所获文献的参考文献。资料选择:筛选所有应用硅凝胶膜治疗病理性瘢痕,对照组为空白或其他治疗的随机、半随机对照试验及临床对照试验,使用Cochrane协作网提供的RevMan4.2.10软件对纳入文献进行统计分析。结局评价指标:主要指标为瘢痕大小,次要指标包括瘢痕颜色、弹性或质地,患者对外观的主观评价,痛、痒等临床症状改善情况,症状改善时间等。结果:硅凝胶膜在改善瘢痕弹性、颜色、患者主观评价方面优于空白对照组,差异有显著性意义(RR弹性=8.60,95%CI2.55～29.02),(RR颜色=21.33,95%CI4.33～104.99),(RR患者主观评价=32.33,95%CI6.63～157.59)。硅凝胶膜不良反应一般较轻,易缓解。结论:硅凝胶膜在改善病理性瘢痕颜色、弹性及患者主观评价方面可能具有一定的疗效,但硅凝胶在改善瘢痕大小方面并无显著疗效。硅凝胶膜并不优于其他治疗方法。可以认为硅凝胶膜治疗病理性瘢痕是安全的。由于纳入的研究质量均低,结果具有高度的偏倚性。BACKGROUND： To evaluate the effectiveness and safety of silicon gel sheeting in treating pathological scars. DATA SOURCES： The following databases were searched by computer： the Cochrane Central Register of Controlled Trials （CENTRAL） （The Cochrane Library issue 3, 2009）, MEDLINE （1966 to September 2009）, EMBase （1980 to September 2009）, China Biological Medicine Database （CBM-disc 1979 to September 2009）, the Chinese VIP database （1989 to September 2009）, and the CNKI China full-text database （1979 to September 2009）. Reference lists of all relevant papers were searched for further studies. DATA SELECTION： Randomized, quasi randomized, controlled, clinical trials and controlled clinical trials comparing silicon gel sheeting with no treatment or other treatments for treating patients of pathological scars were retrieved. Meta-analyses were performed for the results of homogenerous studies by Revman 4.2.10.software. MAIN OUTCOME MEASURES： The primary measure was change in scar size, other measures of clinical outcomes including scar color, skin elasticity, and patients’ subjective opinion, relief of itching and pain, and mean time to symptomatic improvement. RESULTS： Meta-analyses showed that the change of elasticity, color and views of silicon gel sheeting group had significant difference compared to the no treatment group [RRelasticity=8.60, 95% CI （2.55, 29.02）], [RRcolor=21.33, 95% CI （4.33, 104.99）], [RRpatients’ opinion=32.33, 95% CI （6.63, 157.59）]. Adverse reactions of silicon gel sheeting were slight and easy to release. CONCLUSIONS： Silicon gel sheeting seems to help changing the elasticity, color and patients’ views of scars, however, it does not help to change the size of scars, and it is not superior to any of other single treatment. It is suggested that it is safe to use silicon gel sheeting in treating pathological scars. Most of the studies were of poor quality and highly susceptible to bias.

关 键 词：硅凝胶膜 病理性瘢痕 系统评价 

分 类 号：R318[医药卫生—生物医学工程]