负压伤口疗法治疗骨创伤患者创面感染疗效及安全性的Meta分析  

Meta‑analysis of the efficacy and safety of negative‑pressure wound therapy in the treatment of infected wounds in orthopedic trauma patients

作　　者：袁书逸 汤路路 王安素 冯加义 刘晓童 夏同霞 Yuan Shuyi;Tang Lulu;Wang Ansu;Feng Jiayi;Liu Xiaotong;Xia Tongxia(Nursing Department,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;School of Nursing,Zunyi Medical University,Zunyi 563000,China;Department of Spinal Surgery,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China)

机构地区：[1]遵义医科大学附属医院护理部,遵义563000 [2]遵义医科大学护理学院,遵义563000 [3]遵义医科大学附属医院脊柱外科,遵义563000

出　　处：《中华创伤杂志》2025年第1期82-89,共8页Chinese Journal of Trauma

基　　金：中华护理学会2023年度立项科研课题(ZHKY202318)。

摘　　要：目的探讨负压伤口疗法(NPWT)治疗骨创伤患者创面感染的疗效及安全性。方法检索中国知网、中国生物医学文献数据库、万方数据知识服务平台、PubMed、Web of Science、Cochrane Library和CINAHL有关NPWT对骨创伤感染创面愈合影响的随机对照试验(RCT)和队列研究文献。检索时限为建库至2024年10月。应用RevMan 5.4软件进行Meta分析。将患者按照治疗方法的不同分为2组:干预组,采用负压伤口疗法治疗;对照组,采用常规治疗。观察指标包括临床疗效、创面愈合质量、住院时长、创面愈合时长、并发症发生率、二次手术率和抗菌药物使用时长。采用Begg和Egger检验对观察指标进行发表偏倚分析。结果共纳入13篇文献,包括RCT 11篇和队列研究2篇,共3538例患者,其中干预组1762例,对照组1776例。Meta分析结果显示:与对照组比较,干预组临床疗效更好(OR=7.08,95%CI 5.31,9.45,P<0.01),创面愈合质量更高(MD=4.15,95%CI 3.99,4.32,P<0.01),住院时长更短(MD=-13.38,95%CI-14.39,-12.38,P<0.01),创面愈合时长更短(MD=-8.11,95%CI-10.22,-6.00,P<0.01),并发症发生率更低,二次手术率更低(OR=0.22,95%CI 0.09,0.57,P<0.01),抗菌药物使用时长更短(MD=-7.61,95%CI-8.06,-7.16,P<0.01)。同时,以上指标均无明显发表偏倚(P>0.05)。结论与常规治疗比较,NPWT可提高骨创伤患者创面感染的临床疗效和创面愈合质量,缩短住院时长和创面愈合时长,降低并发症发生率和二次手术率,缩短抗菌药物使用时长。Objective To explore the efficacy and safety of negative‑pressure wound therapy(NPWT)in treating infected wounds in orthopedic trauma patients.Methods China National Knowledge Infrastructure,China Biomedical Literature Database,Wanfang Data Knowledge Service Platform,PubMed,Web of Science,Cochrane Library,and CINAHL were searched for randomized controlled trials(RCT)and cohort studies examining the impact of NPWT on wound healing in orthopedic trauma infections.The retrieval time was from the establishment of the databases to October 2024.RevMan 5.4 software was used for Meta‑analysis.The patients were divided into two groups according to different treatment methods:the intervention group,treated with NPWT,and the control group,treated with conventional treatment.The observed indicators included clinical efficacy,wound healing quality,length of hospital stay,wound healing time,incidence of complications,secondary surgery rate,and duration of antibiotic use.Publication bias analysis was performed on the observed indicators through Begg and Egger tests.Results A total of 13 studies were included,comprising 11 RCT and 2 cohort studies,involving a total of 3538 patients,with 1762 in the intervention group and 1776 in the control group.The meta‑analysis results indicated that the intervention group had better clinical efficacy(OR=7.08,95%CI 5.31,9.45,P<0.01),higher wound healing quality(MD=4.15,95%CI 3.99,4.32,P<0.01),shorter length of hospital stay(MD=-13.38,95%CI-14.39,-12.38,P<0.01),shorter wound healing time(MD=-8.11,95%CI-10.22,-6.00,P<0.01),lower incidence of complications,lower secondary surgery rate(OR=0.22,95%CI 0.09,0.57,P<0.01),and shorter duration of antibiotic use(MD=-7.61,95%CI-8.06,-7.16,P<0.01)when compared with the control group.No significant publication bias was observed in the aforementioned indicators(P>0.05).Conclusion Compared with the conventional treatment,NPWT can enhance the clinical efficacy and wound healing quality of infected wounds in orthopedic trauma patients,shorten length of h

关 键 词：医院 骨科 负压伤口疗法 创伤和损伤 感染 META分析 

分 类 号：R641[医药卫生—外科学]