外周血管介入治疗外周动脉病变所致糖尿病足临床疗效的Meta分析  

Meta-analysis of the Clinical Efficacy of Peripheral Vascular Intervention in Treating Diabetic Foot Caused by Peripheral Arterial Disease

作　　者：易琬婷 龙露瑶 邓旭辉 张友来[1] YI Wanting;LONG Luyao;DENG Xuhui;ZHANG Youlai(Department of Burns,The First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330006,China)

机构地区：[1]南昌大学第一附属医院烧伤科,江西南昌330006

出　　处：《中国烧伤创疡杂志》2025年第2期91-95,100,共6页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的系统性分析外周血管介入治疗外周动脉病变所致糖尿病足的临床疗效。方法检索中国学术期刊数据库(万方)、Cochrane Library等数据库自建库至2023年4月公开发表的关于外周血管介入治疗外周动脉病变所致糖尿病足的中英文文献,经筛选后对最终纳入文献进行质量评价与数据分析。结果共纳入文献22篇,质量评价结果显示,仅报告偏倚与其他偏倚均为低风险;Meta分析结果显示,与单纯应用常规治疗相比,联合应用外周血管介入治疗的患者治疗后溃疡愈合有效率更高(RR=1.35,95%CI为1.25~1.46,P<0.00001)、踝肱指数更优(SMD=0.76,95%CI为0.57~0.95,P<0.00001)、溃疡愈合及住院时间更短(SMD=-4.53、-4.08,95%CI为-5.07~-3.99、-4.62~-3.53,P均<0.00001)、截肢率更低(RR=0.35,95%CI为0.22~0.56,P<0.00001);发表偏倚结果显示,溃疡愈合有效率存在发表偏倚(Egger’s检验:P<0.0001;Begg’s检验:P=0.052)。结论与单纯应用常规治疗相比,在其基础上联合应用外周血管介入更有利于改善外周动脉病变所致糖尿病足患者的踝肱指数,提高溃疡愈合有效率,缩短溃疡愈合及住院时间,降低截肢率。Objective To systematically analyze the clinical efficacy of peripheral vascular intervention in treating diabetic foot caused by peripheral arterial disease.Methods Chinese and English literature search was conducted to retrieve studies on peripheral vascular intervention in treating diabetic foot caused by peripheral arterial disease published by April 2023 from the establishment of the databases,including China Science Periodical Database(Wanfang)and Cochrane Library.After screening the retrieved literature,quality assessment and data analysis were performed on the finally included studies.Results A total of 22 studies were included,and quality evaluation showed a low risk of reporting bias and other biases.Meta-analysis showed that,compared with the application of conventional treatment alone,patients with the combined application of peripheral vascular intervention had a higher effective rate of ulcer healing after treatment(RR-1.35,95%CI:1.25-1.46,P<0.00001),better ankle-brachial index(SMD=0.76,95%CI:0.57-0.95,P<0.00001),shorter ulcer healing time and length of stay(SMD=-4.53 and-4.08,95%CI:-5.07--3.99,-4.62--3.53,both P<0.00001),and lower amputation rate(RR=0.35,95%CI:0.22-0.56,P<0.00001).Publication bias results showed that there was a publication bias in the effective rate of ulcer healing(Egger's test:P<0.0001;Begg's test:P=0.052).Conclusion Compared with the application of conventional treatment alone,the addition of peripheral vascular intervention is more effective in improving ankle-brachial index,increasing effective rate of ulcer healing,shortening ulcer healing time and length of stay,and reducing amputation rate in patients with diabetic foot caused by peripheral arterial disease.

关 键 词：外周血管介入 糖尿病足 外周动脉病变 随机对照试验 荟萃分析 

分 类 号：R47[医药卫生—护理学]