软聚硅酮泡沫敷料对放射性皮肤损伤影响的Meta分析  

Meta-analysis of clinical efficacy of soft silicone dressing for treating radiation-induced skin reaction

作　　者：史雪萍 雷友金[2] 曾珠梅 罗江荷 黄锐娜 杨明[1] Shi Xueping;Lei Youjin;Zeng Zhumei;Luo Jianghe;Huang Ruina;Yang Ming(Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China)

机构地区：[1]广州中医药大学,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

出　　处：《中国组织工程研究》2019年第22期3591-3598,共8页Chinese Journal of Tissue Engineering Research

基　　金：广州中医药大学“薪火计划”资助项目(XH20170201),项目负责人:杨明~~

摘　　要：背景:研究证实,软聚硅酮泡沫敷料在防治放射性皮肤损伤方面具有良好效果,但由于现有研究样本量较少,因此有必要借助Meta分析方法对软聚硅酮泡沫敷料在放疗患者中的临床应用效果进行评价。目的:探讨软聚硅酮泡沫敷料与常规护理措施防治放射性皮肤损伤的疗效差异。方法:检索中国知网、中国生物医学数据库、万方数据库、PubMed、COCHRANE LIBRARY等数据库,查找关于软聚硅酮泡沫敷料和常规护理对放射性皮肤损伤患者临床疗效的临床随机对照试验或非随机对照试验,再用Rev Man 5.3系统评价软件进行统计学分析。结果与结论:纳入分析文献11篇,包含1 284例癌症患者,其中试验组采用软聚硅酮泡沫敷料防治放疗中的放射性皮肤损伤,对照组采用常规护理措施防治放疗中的放射性皮肤损伤。Meta分析显示:与对照组比较,试验组湿性脱屑发生率降低[OR=0.13,95%CI(0.09,0.19),P<0.05]、Ⅱ,Ⅲ,Ⅳ级皮肤损伤发生率降低[OR=0.30,95%CI(0.21,0.44),P<0.05;OR=0.14,95%CI(0.07,0.28),P<0.05;OR=0.06,95%CI(0.01,0.47),P<0.05]、RISRAS联合评分减低[OR=-1.12,95%CI(-2.21,-0.04),P<0.05]、患者疼痛程度减轻[MD=-1.44,95%CI(-1.93,-0.95),P<0.05]、无痛发生率增加[OR=4.83,95%CI(2.93,7.99),P<0.05]、伤口愈合时间缩短[OR=-6.03,95%CI(-7.47,-4.59),P<0.05]。结果表明与常规干预措施比较,软聚硅酮泡沫敷料具有减轻放射性皮肤损伤严重程度、降低伤口疼痛程度及缩短伤口愈合时间的优势,是一种合理有效的防治放射性皮肤损伤方式。BACKGROUND:Soft silicone dressing has been reported to improve the skin situation for patients suffering from radiotherapy,but these studies are small-sample trials.Therefore,it is necessary to evaluate the studies at home and abroad addressing that soft silicone dressing applied in the patients undergoing radiotherapy by meta-analysis.OBJECTIVE:To investigate the differences in the effectiveness of soft silicone dressing and conventional nursing in the prevention and treatment of radiation-induced skin reaction.METHODS:Databases of CNKI,CBM,WanFang,PubMed,and Cochrane Library were searched to retrieve the randomized clinical trials or non-randomized clinical trials concerning the effects of soft silicone dressing and conventional nursing in radiation-induced skin reaction.Meta-analysis was conducted using RevMan 5.3 software.RESULTS AND CONCLUSION:Eleven studies were enrolled,involving 1 284 patients.The patients received the soft silicone dressing(trial group)and conventional nursing(control group)to treat and prevent radiation-induced skin reaction.Meta-analysis revealed that compared with the control group,in the trial group,there was an decrease the incidence of moist desquamation[OR=0.13,95%CI(0.09,0.19,P<0.05],grade II,III and IV[OR=0.30,95%CI(0.21,0.44),P<0.05;OR=0.14,95%CI(0.07,0.28),P<0.05;OR=0.06,95%CI(0.01,0.47),P<0.05],combined RISRAS score was decreased[OR=-1.12,95%CI(-2.21,-0.04,P<0,05],pain degree was alleviated[MD=-1.44,95%CI(-1.93,-0.95),P<0.05],incidence of painless was increased[OR=4.83,95%CI(2.93,7.99),P<0.05],and the wound healing time was shortened[OR=-6.03,95%CI(-7.47,-4.59,P<0.05].These results indicate that soft silicone dressing can relieve the severity of radiation-induced skin reaction and pain,and accelerate wound healing compared with the conventional nursing,which is a rational and effective method in the prevention and treatment of radiation-induced skin reaction.

关 键 词：软聚硅酮泡沫敷料 放射性皮肤损伤 放射性皮炎 常规护理 湿性脱屑 RTOG RISRAS 疼痛 愈合时间 META分析 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学]