负压治疗联合滴注冲洗对感染性伤口治疗效果的Meta分析  

Meta-analysis of the Effect of Negative Pressure Wound Therapy with Instillation on the Treatment of Infected Wounds

作　　者：刘妍 谢松林[2] 罗思远 莫文娟 李颖[2] 胡小萍[2] LIU Yan;XIE Songlin;LUO Siyuan;MO Wenjuan;LI Ying;HU Xiaoping(School of Nursing,Hengyang Medical School,University of South China,Hengyang,Hunan 421001;Affiliated Nanhua Hospi-tal,University of South China,Hengyang,Hunan 421001;School of Nuclear Science and Technology,Univer-sity of South China,Hengyang,Hunan 421001)

机构地区：[1]南华大学衡阳医学院护理学院,湖南衡阳421001 [2]南华大学附属南华医院,湖南衡阳421001 [3]南华大学核科学技术学院,湖南衡阳421001

出　　处：《上海护理》2023年第2期53-59,共7页Shanghai Nursing

基　　金：湖南省卫生计生科研计划项目(20201906);衡阳市指导性计划项目(社会发展领域-125);南华大学护理学院研究生科研创新项目(KYCX202220)。

摘　　要：目的系统评价负压治疗联合滴注冲洗对感染性伤口的治疗效果。方法检索国内外各数据库2022年5月前发表的有关负压治疗联合滴注冲洗对感染性伤口治疗效果的研究,使用RevMan 5.4以及R Studio 4.2.1软件对纳入文献进行系统评价。结果最终纳入15篇文献,共涉及996例研究对象。与传统负压伤口治疗相比,负压治疗联合滴注冲洗能有效降低引流管的堵管率[OR=0.11,95%CI(0.05,0.28),P<0.001],提高伤口闭合率[OR=1.99,95%CI(1.38,2.87),P<0.001]和细菌清除率[OR=18.04,95%CI(16.77,19.31),P<0.001],缩短感染性伤口的闭合时间[MD=-3.15,95%CI(-3.15,-2.34),P<0.001]。而对于滴注冲洗液的选择,生理盐水与抗菌溶液两个亚组的伤口闭合率和伤口闭合时间的合并效应量差异均无统计学意义(P=0.226,P=0.568)。结论负压治疗联合滴注冲洗能促进感染性伤口的闭合,抑制局部感染与细菌繁殖,提高感染性伤口负压治疗的效果,且负压吸引联合生理盐水滴注冲洗与抗菌溶液冲洗的疗效相当。Objective To systematically evaluate the effect of negative pressure wound therapy with instillation on the treatment of infected wounds.Methods Studies on the effect of negative pressure wound therapy with instillation on the treatment of infected wounds published before May 2022 were retrieved in databases at home and abroad,and the included articles were systematically reviewed using RevMan 5.4 and R Studio 4.2.1 software.Results A total of 15 articles were included,involving 996 subjects.Compared with the traditional negative pressure wound therapy,negative pressure wound therapy with instillation effectively reduced drainage tube blocking rate[OR=0.11,95%CI(0.05,0.28),P<0.001]and shorten the infected wound closure time[MD=-3.15,95%CI(-3.15,-2.34),P<0.001].For the choice of instillation solutions,there was no significant difference in the pooled effect size of wound closure rate and wound closure time between the saline subgroup and antiseptic solution subgroup(P=0.226,P=0.568).Conclusion Negative pressure wound therapy with instillation can accelerate the closure of infected wounds,inhibit local infection and bacterial reproduction,and enhance the effect of negative pressure wound therapy on the wounds.Besides,the effect of negative pressure wound therapy with saline instillation was similar to that of negative pressure wound therapy with antiseptic solution instillation.

关 键 词：负压伤口疗法 滴注 药物 灌洗疗法 伤口感染 META分析 

分 类 号：R473.5[医药卫生—护理学]