负压封闭引流技术治疗毒蛇咬伤的疗效及安全性Meta分析  

Meta-Analysis of the Efficacy and Safety of Vacuum Sealing Drainage in the Treatment of Venomous Snake Bite

作　　者：赵雷 郭庆[1,2] 姚邦燕 Zhao Lei;Guo Qing;Yao Bangyan(Department of Emergency,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China;Clinical Nursing Research Center of China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]急诊科,湖北宜昌443003 [2]三峡大学临床护理研究中心,湖北宜昌443003

出　　处：《巴楚医学》2025年第1期35-42,共8页Bachu Medical Journal

基　　金：湖北省联合基金培育项目(2024AFD184)。

摘　　要：目的:探讨负压封闭引流技术(VSD)治疗毒蛇咬伤的有效性及安全性。方法:计算机检索Cochrane Library、PubMed、Embase、Web of Science、中国知网、万方、维普、中国生物医学文献等数据库,收集VSD治疗毒蛇咬伤的随机对照试验,对符合纳入标准的临床研究进行资料提取,采用Cochrane系统评价员手册5.0版进行质量评价,采用RevMan 5.3和STATA 16软件进行Meta分析。结果:共纳入20项原始研究,合计1774例患者。Meta分析结果显示,VSD治疗毒蛇咬伤总有效率显著高于常规切开引流(RR=1.18,95%CI:1.11,1.26),患者住院时间(MD=-6.52,95%CI:-6.95,-6.08)、患肢肿胀消退时间(MD=-3.57,95%CI:-4.27,-2.87)、植皮/二期缝合时间(MD=-4.35,95%CI:-4.74,-3.97)、创面感染发生率(RR=0.24,95%CI:0.15,0.37)及皮肤坏死发生率(RR=0.30,95%CI:0.21,0.43)均显著降低(均P<0.05)。结论:负压封闭引流技术治疗毒蛇咬伤的安全性及疗效均较好。Objective:To explore the efficacy and safety of vacuum sealing drainage(VSD)technology in the treatment of snake bites.Methods:We conducted the retrieval of databases,including the Cochrane Library,PubMed,Embase,Web of Science,CNKI,Wanfang,VIP and CBM,to collect randomized controlled trials on VSD treatment for snake bites.Data from clinical studies that meet the inclusion criteria were extracted and evaluated the quality using the Cochrane Handbook for Systematic Reviews 5.0.Meta-analysis was performed using RevMan 5.3 and STATA 16 software.Results:A total of 20 original studies involving 1,774 patients were included.Meta-analysis results showed that the overall effective rate of VSD treatment for snake bites was significantly higher than that of conventional incision and drainage(RR=1.18,95%CI:1.11,1.26).The number of hospitalization days(MD=-6.52,95%CI:-6.95,-6.08),days for limb swelling reduction(MD=-3.57,95%CI:-4.27,-2.87),days for skin grafting or second intention healing(MD=-4.35,95%CI:-4.74,-3.97),incidence of wound infection(RR=0.24,95%CI:0.15,0.37),and incidence of skin necrosis(RR=0.30,95%CI:0.21,0.43)were all significantly reduced(all P<0.05).Conclusion:The safety and efficacy of vacuum sealing drainage technology in treating snake bites are both good.

关 键 词：负压封闭引流技术 毒蛇咬伤 META分析 

分 类 号：R646[医药卫生—外科学]