应用负压技术治疗高位肛周脓肿效果的meta分析  

Application of negative pressure wound therapy in the treatment of high perianal abscess:a meta analysis

作　　者：欧阳暂 周丽 刘红[1] 徐征[1] 郑帆[1] OUYANG Zan;ZHOU Li;LIU Hong;XU Zheng;ZHENG Fan(Department of Anorectal,Deyang People′s Hospital,Deyang,Sichuan 618000,China)

机构地区：[1]德阳市人民医院肛肠科,四川德阳618000

出　　处：《现代医药卫生》2021年第17期2926-2930,2936,共6页Journal of Modern Medicine & Health

摘　　要：目的 评估负压创面治疗技术(以下简称负压技术)应用于高位肛周脓肿治疗的安全性及有效性。方法 检索万方、知网、维普、Embase、Web of science、PubMed、Cochrane library等主要数据库,筛选使用负压技术治疗高位肛周脓肿的随机对照临床试验,检索年限为1964年1月至2020年1月。使用CONSORT清单初步评价文献质量,使用Cochrane协作网提供的偏移风险评估量表对所有纳入文献进行二次质量评价,所有文献评价工作由两位评价者分别独立完成,最后使用RevMan5.3软件进行meta分析。结果 共检索到468篇文献,最终纳入6篇,样本量为368例,meta分析结果显示,使用负压技术治疗高位肛周脓肿可减轻术后疼痛,观察组视觉模拟评分法(VAS)低于对照组(MD=-1.67,95%CI-1.91~-1.44,P<0.001),观察组的手术并发症发生率低于对照组(OR=0.27,95%CI 0.12~0.64,P=0.003),且使用负压技术可以取得更高的痊愈率及更低的复发率、成瘘率(痊愈率:OR=4.30,95%CI 2.38~7.79,P<0.001;复发率:OR=0.28,95%CI 0.11~0.73,P=0.009;成瘘率:OR=0.27,95%CI 0.13~0.60,P=0.001),观察组的平均创面愈合时间短于对照组(MD=-12.78,95%CI-18.64~-6.93,P<0.001)。结论 相较于传统切开引流术加术后换药的治疗方案,以负压技术为核心的治疗方案可取得更好的临床效果。Objective To evaluate the safety and effectiveness of negative pressure wound therapy(NPWT)in the treatment of highperianal abscess.Methods All related randomized controlled trials,published from January 1964 to January 2020,were retrieved from PubMed,Cochrane library,Embase,Web of science,CNKI,Wanfang,VIP databases and other databases.The CONSORT checklist was used to conduct a preliminary literature quality assessment,and all included documents were then subjected to a secondary quality assessment through the offset risk scale provided by the Cochrane library.By twoindependent reviewers,data were extracted and evaluated with a designed extraction form,and the RevMan5.3 software was used for meta-analysis on homogeneous studies.Results A total of 468 literatures were retrieved,and 6 articles were included in this study,involving 368 cases.Meta analysis results showed those using NPWT to treat highperianal abscess could reduce the postoperative pain of patients,and the visual analogue scale(VAS)of observation group was lower than that of the control group(MD=-1.67,95%CI-1.91--1.44,P<0.001),the incidence of surgical complications in the observation group was lower than that in the control group(OR=0.27,95%CI 0.12-0.64,P=0.003),and using NPWT could achieve higher cure rate,lower recurrence rate and lower fistula formation rate(cure rate:OR=4.30,95%CI 2.38-7.79,P<0.001;recurrence rate:OR=0.28,95%CI 0.11~0.73,P=0.009;fistula formation rate:OR=0.27,95%CI 0.13~0.60,P=0.001),the average wound healing time of the observation group was shorter than that of the control group(MD=-12.78,95%CI-18.64--6.93,P<0.001).Conclusion Compared with the traditional treatment program,the treatment programs with NPWT as the core can achieve better clinical results.

关 键 词：高位肛周脓肿 负压引流 切开引流 META分析 

分 类 号：R735.2[医药卫生—肿瘤]