异种脱细胞真皮基质敷料治疗烧伤患者创面效果的荟萃分析  

Meta-analysis of the effects of xenogeneic acellular dermal matrix dressings in the treatment of wounds in burn patients

作　　者：游艾佳 李文婕 周俊丽 李春[1] Aijia You;Wenjie Li;Junli Zhou;Chun Li(School of Nursing,Guangzhou University of Chinese Medicine,Guangzhou 510006,China)

机构地区：[1]广州中医药大学护理学院,广州510006

出　　处：《中华烧伤与创面修复杂志》2023年第2期175-183,共9页Chinese Journal of Burns And Wounds

基　　金：广东省教育厅高校特色创新项目(2020KTSCX025)。

摘　　要：目的评价异种脱细胞真皮基质(ADM)敷料治疗烧伤患者创面的有效性和安全性。方法采用荟萃分析方法。以“异种脱细胞真皮基质、敷料、烧伤创面、烧伤”为中文检索词检索《中国期刊全文数据库》《万方数据库》《维普数据库》《中国生物医学文献数据库》,以“xenogeneic acellular dermal matrix、dressing、burn wound、burn”为英文检索词检索《PubMed》《Embase》《Web of Science》《Cochrane Library》数据库,收集自建库起至2021年12月公开发表的关于异种ADM敷料治疗烧伤患者创面效果的随机对照试验。结局指标包括创面愈合时间、瘢痕增生比例、温哥华瘢痕量表(VSS)评分、并发症发生比例、植皮比例、细菌检出比例。采用Rev Man 5.3和Stata 14.0统计软件对符合纳入标准的研究进行荟萃分析。结果共纳入16篇文献1596例烧伤患者,包括接受异种ADM敷料治疗的试验组835例患者和接受其他方式治疗的对照组761例患者。纳入的16项研究偏倚风险不明确。与对照组比较,试验组患者的创面愈合时间明显缩短、VSS评分明显降低(标准化均数差分别为-2.50、-3.10,95%置信区间分别为-3.02~-1.98、-4.87~-1.34,P值均<0.05),瘢痕增生比例、并发症发生比例、植皮比例、细菌检出比例均明显降低(相对危险度分别为0.58、0.23、0.32、0.27,95%置信区间分别为0.43~0.80、0.14~0.37、0.15~0.67、0.11~0.69,P<0.05)。亚组分析显示,对照组干预措施可能是创面愈合时间的异质性来源。瘢痕增生比例不存在发表偏倚(P≥0.05),创面愈合时间、VSS评分、并发症发生比例均存在发表偏倚(P<0.05)。结论异种ADM敷料可缩短烧伤患者创面愈合时间,降低VSS评分、瘢痕增生比例、并发症发生比例、植皮比例、细菌检出比例。Objective To evaluate the efficacy and safety of xenogeneic acellular dermal matrix(ADM)dressings for the treatment of wounds in burn patients.Methods The meta-analysis method was adopted.Databases including Chinese Journal Full-text Database,Wanfang Database,VIP Database,and Chinese Biomedical Database were retrieved with the search terms in Chinese version of"异种脱细胞真皮基质,敷料,烧伤创面,烧伤"and PubMed,Embase,Web of Science,and Cochrane Library were retrieved with the search terms in English version of"xenogeneic acellular dermal matrix,dressing,burn wound,burn"to obtain the publicly published randomized controlled trials on the efficacy of xenogeneic ADM dressings for the treatment of wounds in burn patients from the establishment of each database to December 2021.The outcome indexes included wound healing time,ratio of scar hyperplasia,Vancouver scar scale(VSS)score,ratio of complications,ratio of skin grafting,and ratio of bacteria detection.Rev Man 5.3 and Stata 14.0 statistical softwares were used to conduct a meta-analysis of eligible studies.Results A total of 1596 burn patients from 16 studies were included,including 835 patients in experimental group who received xenogeneic ADM dressings therapy and 761 patients in control group who received other methods therapy.The bias risk of all the 16 included studies was uncertain.Compared with those in control group,patients in experimental group had significantly shorter wound healing time,lower VSS scores(with standardized mean differences of-2.50 and-3.10,95%confidence intervals of-3.02--1.98 and-4.87--1.34,respectively,P values both<0.05),and lower ratios of scar hyperplasia,complications,skin grafting,and bacteria detection(with relative risks of 0.58,0.23,0.32,and 0.27,95%confidence intervals of 0.43-0.80,0.14-0.37,0.15-0.67,and 0.11-0.69,respectively,P<0.05).Subgroup analysis showed that the difference of intervention measures in control group might be the source of heterogeneity in wound healing time.There was no publication bias i

关 键 词：烧伤 生物敷料 异种脱细胞真皮基质敷料 荟萃分析 

分 类 号：R644[医药卫生—外科学] R318.08[医药卫生—临床医学]