银离子敷料在慢性难愈性创面中的应用效果及安全性的Meta分析  

Meta analysis of the effect and safety of silver ion-based dressings in chronic diffi cult-to-heal wounds

作　　者：东瑞 吴玉娇 孙雨婷 唐宗哲 张茹 王洁 DONG Rui;WU Yujiao;SUN Yuting;TANG Zongzhe;ZHANG Ru;WANG Jie(Nursing School of Nanjing Medical University,Nanjing,211166,China)

机构地区：[1]南京医科大学护理学院基础与社区护理学系,江苏省南京市211166

出　　处：《护理实践与研究》2023年第21期3236-3244,共9页Nursing Practice and Research

基　　金：江苏高校优势学科建设工程三期项目(编号:苏政办发[2018]87号)

摘　　要：目的系统评价银离子类敷料治疗慢性难愈性创面的促愈、减痛效果和安全性。方法计算机检索从建库至2022年9月6日PubMed、The Cochrane Library、Embase、Web of Science、中国知网、中国生物医学文献数据库、万方数据库及维普数据库中,关于银离子类敷料治疗慢性难愈性伤口的随机对照试验。经2名研究人员独立筛选文献、提取资料与评价文献质量后,应用Revman5.4软件行Meta分析。结果筛选后最终纳入21篇文献,共2096例样本。其中观察组采用银离子类敷料进行治疗,对照组采用不含银离子的其他类型敷料。Meta分析结果显示,银离子类敷料治疗组的CRWs痊愈率(OR=1.86,95%CI:1.30~2.66)和创面面积缩小率(MD=19.21%,95%CI:17.02~21.39)均高于对照组,而其平均换药次数(MD=-5.95,95%CI:-6.47~-5.44)、换药相关性疼痛评分(MD=-2.48,95%CI:-2.85~-2.11)、创面细菌阳性率(OR=0.16,95%CI:0.08~0.31,)和不良反应发生率(OR=0.37,95%CI:0.18~0.80)则均低于对照组。结论当前证据表明,与其他类型敷料相比,银离子类敷料可更好地促进慢性难愈性创面的愈合、缓解疼痛,且安全性好。Objective To systematically evaluate the healing-promoting and pain-reducing effects and safety of silver ion-based dressings for the treatment of chronic hard-to-heal wounds.Methods A computerized search was performed from the establishment of the database to 6 September 2022 in PubMed,The Cochrane Library,Embase,Web of Science,China Knowledge Network,China Biomedical Literature Database,Wanfang Database,and Weipu Database for randomized controlled trials on the treatment of chronic hard-to-heal wounds with silver ion-based dressings.After two researchers independently screened the literature,extracted the data and evaluated the quality of the literature,Metaanalysis was performed using Revman 5.4 software.Results After screening,21 papers with 2096 samples werefinally included.The observation group was treated with silver ion-based dressings,and the control group was treated with other types of dressings without silver ions.Meta-analysis showed that the silver ion-based dressing treatment group had a higher rate of healing of CRWs(OR=1.86,95%CI:1.30~2.66)and reduction of wound area(MD=19.21%,95%CI:17.02~21.39)than the control group,and their mean dressing change was higher than the control group,while their mean dressing change was higher than the control group,and their mean dressing change was higher than the control group.control group,while their mean number of dressing changes(MD=-5.95,95%CI:-6.47~-5.44),dressing change-associated pain scores(MD=-2.48,95%CI:-2.85~-2.11),trauma bacterial positivity rate(OR=0.16,95%CI:0.08~0.31,)and incidence of adverse reactions(OR=0.37,95%CI:0.18~0.80)were lower than those of the control group.Conclusion Current evidence suggests that silver ion-based dressings may better promote healing of chronic difficult-to-heal wounds,relieve pain,and have a good safety profile compared with other types of dressings.

关 键 词：银离子敷料 慢性难愈性伤口 疗效评价 随机对照试验 META分析 

分 类 号：R47[医药卫生—护理学]