自体富血小板血浆/凝胶联合负压封闭引流术治疗糖尿病足溃疡的荟萃分析
Autologous platelet-rich plasma/gel combined with negative pressure sealed drainage for treatment of diabetic foot ulcers:A Meta-analysis
张艺 1王思雨 1杨晴 1刘春华1
作者信息
- 1. 湖南中医药大学第二附属医院心血管内科,湖南长沙 410005
- 折叠
摘要
目的 评估联合运用自体富血小板血浆/凝胶(PRP/APG)和负压封闭引流技术(VSD)治疗糖尿病足溃疡的效果及安全性.方法 应用计算机检索PubMed、EMbase、The Cochrane Library、中国知网(CNKI)、维普、万方数据库,检索应用PRP/APG联合VSD治疗糖尿病足溃疡的随机对照研究,检索时限设为建库至2022年4月.由2名研究人员独立进行文献筛选、数据提取、评估偏倚风险,随后采用RevMan 5.3软件对数据进行荟萃分析并进行总结.结果 纳入17篇随机对照研究,涵盖1 338例患者,其中观察组(PRP/APG联合VSD)668例,对照组(常规治疗或VSD)670例.Meta分析结果显示,观察组治疗有效率高于对照组[比值比(OR)=7.35,95％可信区间(CI)5.04～10.70,P＜0.000 01];溃疡愈合时间短于对照组[均数差(MD)=-9.32,95％CI-10.63～-8.01,P＜0.000 01];住院时间少于对照组(MD=-13.51,95％CI-14.09～-12.92,P＜0.000 01);并发症发生率低于对照组(OR=0.16,95％CI 0.07～0.38,P＜0.000 01);对照组血管内皮生长因子(VEGF)浓度低于观察组(MD=4.57,95％CI 3.84～5.31,P＜0.000 01);观察组碱性成纤维细胞生长因子(bFGF)浓度高于对照组(OR=2.86,95％CI 2.36～3.36,P＜0.000 01).结论 PRP/APG联合VSD可以有效提高糖尿病足溃疡愈合率,减少愈合时间、住院时间、并发症,并可提高VEGF、bFGF浓度促进溃疡愈合,具有较好的临床疗效.
Abstract
Objective To evaluate the effectiveness and safeties of autologous platelet-rich gel(APG)/platelet-rich plasma(PRP)combined with vacuum sealing drain(VSD)in treatment of diabetic foot ulcers.Methods A comprehensive computer search was conducted across databases including PubMed,EMbase,The Cochrane Library,China National Knowledge Infrastructure(CNKI),and VIP databases.The randomized controlled trials of PRP/APG combined with VSD in treatment diabetic foot ul-cers were searched from inception to April 2022.Two researchers screened literature,extracted data,and assessed the risk of bias,independently.RevMan 5.3 software was used for Meta-analysis and summary of the data.Results A total of 17 randomized controlled trials involving 1 338 patients were enrolled,which included 668 patients in observation group(PRP/APG combined with VSD)and 670 in control group(conventional treatment or VSD).The results of Meta-analysis showed that treatment effective rate in observation group was higher than that in control group[odds ratio(OR)=7.35,95％confidence in-terval(CI)5.04-10.70,P＜0.000 01];ulcer healing time in observation group was shorter than that in control group[mean di-viation(MD)=-9.32,95％CI-10.63--8.01,P＜0.000 01];hospitalization time in observation group was less than that in control group(MD=-13.51,95％CI-14.09--12.92,P＜0.000 01);complication rates in observation group was lower than that in control group(OR=0.16,95％CI 0.07-0.38,P＜0.000 01);concentration of vascular endothelial growth factor(VEGF)in control group was lower than that in observation group(MD=4.57,95％CI 3.84-5.31,P＜0.000 01);concentration of ba-sic fibroblast growth factor(bFGF)in observation group was higher than that in control group(OR=2.86,95％CI 2.36-3.36,P＜0.000 01].Conclusion It is demonstrated that PRP/APG combined with VSD could effectively improve healing rate of dia-betic foot ulcers,reduce healing time,hospitalization time and complications,and increase the concentration of VEGF and bFGF to promote ulcer healing,which showed good clinical efficacy.
关键词
自体富血小板血浆/自体富血小板凝胶/Meta分析/糖尿病足/负压封闭引流/糖尿病足溃疡Key words
platelet-rich plasma/autologous platelet-rich gel/Meta-analysis/diabetic foot/vacuum sealing drainage/diabetic foot ulcer引用本文复制引用
基金项目
湖南省教育厅科研项目(22A0269)
湖南中医药大学校级科研项目(2022CX165)
出版年
2024
NETL
NSTL
万方数据