中国糖尿病足溃疡创面病人治疗的网状Meta分析  

THE TREATMENT OF DIABETIC FOOT ULCERS IN CHINA: A NETWORK META-ANALYSIS

作　　者：周琪[1] 莫志洋 孙爱杰 孙鹏飞 王培培[5] ZHOU Qi;MO Zhiyang;SUN Aijie;SUN Pengfei;WANG Peipei(Department of Orthopaedic Trauma,Zibo Central Hospital,Zibo 255000,China)

机构地区：[1]淄博市中心医院创伤骨科,山东淄博255000 [2]青海省人民医院颌面整形外科 [3]淄博市中心医院整形美容外科 [4]中国医学科学院整形外科医院整形七科 [5]菏泽市立医院烧伤整形外科

出　　处：《青岛大学学报（医学版）》2022年第6期818-822,共5页Journal of Qingdao University(Medical Sciences)

基　　金：国家自然科学基金面上项目(81571863)。

摘　　要：目的 比较常规外科换药、富血小板血浆、负压吸引疗法、富血小板血浆联合负压吸引疗法、重组牛碱性成纤维细胞生长因子凝胶5种临床常用的糖尿病足溃疡治疗方法的疗效,以期为糖尿病足溃疡的临床治疗提供循证医学证据。方法 以“糖尿病足”“富血小板血浆”“负压吸引”“成纤维细胞生长因子”等为关键词,检索万方、维普、知网、PubMed、Cochrane Library和Web of Science等中英文数据库中糖尿病足溃疡治疗的相关研究论文,检索时间从数据库建库到2021年12月。提取各文献糖尿病足溃疡治疗有效率的相关数据进行网状Meta分析,通过计算5种治疗措施治愈率比较的相对危险度(RR)值及95%置信区间(CI)评估各治疗措施治愈率差异是否存在统计学意义;绘制5种糖尿病足溃疡疗法的优选概率排名曲线(SUCRA)图,根据曲线下面积预测各治疗措施的疗效并进行排序。结果 共检索到包含5种糖尿病足溃疡治疗方法论文19篇1 304例病人的相关数据。网状Meta分析显示,富血小板血浆疗法的疗效优于常规外科换药(RR=0.82,95%CI=0.75~0.90,P<0.05)及重组牛碱性成纤维细胞生长因子凝胶(RR=0.83,95%CI=0.69~0.99,P<0.05),但与富血小板血浆联合负压吸引疗法(RR=1.11,95%CI=0.96~1.30,P>0.05)及负压吸引疗法比较差异无统计学意义(RR=0.84,95%CI=0.69~1.03,P>0.05)。SUCRA曲线预测的5种糖尿病足溃疡疗法的疗效排序为:富血小板血浆联合负压吸引疗法>富血小板血浆疗法>负压吸引疗法>重组牛碱性成纤维细胞生长因子凝胶疗法>常规外科换药疗法。结论 对中国糖尿病足溃疡的临床治疗推荐富血小板血浆联合负压吸引疗法。Objective To compare the efficacy of five commonly used therapies for diabetic foot ulcers, i.e., conventional dressing change, platelet-rich plasma, negative pressure suction, platelet-rich plasma combined with negative pressure suction, and recombinant bovine basic fibroblast growth factor gel, and to provide evidence-based medicine support for the clinical treatment of diabetic foot ulcers. Methods With the keywords including “diabetic foot”, “platelet-rich plasma”, “negative pressure suction”, and “fibroblast growth factor”, Chinese and English databases such as Wanfang Data, VIP, CNKI, PubMed, the Cochrane Libra-ry, and Web of Science were searched for the articles on the treatment of diabetic foot ulcers published up to December 2021. Rela-ted data on the response rate of diabetic foot ulcers were extracted for the network Meta-analysis, and the values of relative risk(RR) and 95% confidence interval(CI) were calculated for the cure rates of the above five treatment measures to investigate whether there was a significant difference in cure rate. The surface under the cumulative ranking curve(SUCRA) was determined for each therapy to predict and compare the efficacy of the five commonly used therapies for diabetic foot ulcers. Results A total of 19 articles on the five therapies for diabetic foot ulcers were included in this meta-analysis, with 1 304 patients in total. The network Meta-analysis showed that platelet-rich plasma therapy had significantly better efficacy than conventional dressing change(RR=0.82,95%CI=0.75-0.90,P<0.05) and recombinant bovine basic fibroblast growth factor gel(RR=0.83,95%CI=0.69-0.99,P<0.05), but with similar efficacy to platelet-rich plasma combined with negative pressure suction(RR=1.11,95%CI=0.96-1.30,P>0.05) and negative pressure suction(RR=0.84,95%CI=0.69-1.03,P>0.05). The SUCRA curve predicted that platelet-rich plasma combined with negative pressure suction had the best efficacy in the treatment of diabetic foot ulcers, followed by platelet-rich plasma, ne

关 键 词：糖尿病足 富血小板血浆 负压伤口疗法 足溃疡 META分析 

分 类 号：R587.29[医药卫生—内分泌]