5种常用敷料预防高危风险患者压疮的网状Meta分析
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摘要
目的:采用网状Meta分析评价5种常用敷料预防高危风险患者压疮的临床疗效。方法:以dressing、bandage、decubitus ulcer、pressure sore、bedsore、pressure ulcer、randomized clinical trials、敷料、贴敷、绷带、压疮、压力性溃疡、压力性损伤为关键词,检索PubMed、Elsevier、Embase、中国知网(CNKI)、维普数据库、万方数据库,检索时间为建库至2018年4月30日。由2名研究者分别进行文献筛选、资料提取及质量评价,采用ADDIS 1.16.8软件进行统计分析。结果:共纳入21个研究(2 443名患者)。网状Meta分析结果显示,5种敷料预防高危风险患者压疮疗效优于常规护理措施。根据疗效概率排序表可知液体敷料、泡沫敷料预防高危风险患者压疮效果较好。结论:液体敷料和泡沫敷料预防高危风险患者压疮效果优于其他敷料。
Objective To evaluate the effects of five common dressings in the prevention of pressure ulcer in patients at high risk. Methods Literature retrieval on bandage, decubitus ulcer, pressure sore, bedsore, pressure ulcer, randomized clinical trials in English and Chinese was executed with the databases of PubMed, Elsevier, Embase, CNKI, VIP and Wanfang, and the time was restricted within when database was founded to April 30 th 2018. Literature screening, data extraction and quality evaluation were carried out by two researchers independently. ADDIS 1.16.8 software was used for statistical analysis.Results There were totally 21 RCTs(2 443 patients) were included. The results of network Meta-analysis showed that the five common dressings were superior to routine nursing measures in the prevention of pressure ulcer in patients at high risk. The ranking results proved that liquid dressing and foam dressing behaved better when used in the prevention of pressure ulcer in patients at high risk. Conclusion Liquid dressing and foam dressing are superior to other dressings in the prevention of pressure ulcer in patients at high risk.
Objective To evaluate the effects of five common dressings in the prevention of pressure ulcer in patients at high risk. Methods Literature retrieval on bandage, decubitus ulcer, pressure sore, bedsore, pressure ulcer, randomized clinical trials in English and Chinese was executed with the databases of PubMed, Elsevier, Embase, CNKI, VIP and Wanfang, and the time was restricted within when database was founded to April 30 th 2018. Literature screening, data extraction and quality evaluation were carried out by two researchers independently. ADDIS 1.16.8 software was used for statistical analysis.Results There were totally 21 RCTs(2 443 patients) were included. The results of network Meta-analysis showed that the five common dressings were superior to routine nursing measures in the prevention of pressure ulcer in patients at high risk. The ranking results proved that liquid dressing and foam dressing behaved better when used in the prevention of pressure ulcer in patients at high risk. Conclusion Liquid dressing and foam dressing are superior to other dressings in the prevention of pressure ulcer in patients at high risk.
引文
[1]QASEEM A,MIR T P,STARKEY M,et al. Risk assessment and prevention of pressure ulcers:a clinical practice guideline from the American College of Physicians[J]. Ann Intern Med,2015,162(5):359-369.
[2]LYDER C H,WANG Y,METERSKY M,et al. Hospital-acquired pressure ulcers:results from the national Medicare Patient Safety Monitoring System study[J]. J Am Geriatr Soc,2012,60:1 603-1 608.
[3]SPILSBURY K,NELSON A,CULLUM N,et al. Pressure ulcers and their treatment and effects on quality of life:hospital inpatient perspectives[J]. J Adv Nurs,2007,57(5):494-504.
[4]TSCHANNEN D,BATES O,TALSMA A N,et al. Patientspecific and surgical characteristics in the development of pressure ulcers[J]. Am J Crit Care,2012,21(2):116-125.
[5]张珺,李荣科,陈可欣,等.敷料预防无创正压通气鼻面部压疮效果的网状Meta分析[J].护理学杂志,2016,31(2):102-106.
[6]田金徽,李伦,赵晔,等.网状Meta分析的撰写与报告[J].中国药物评价,2013,30(6):321-323,333.
[7]孙淮庆.软聚硅酮泡沫敷料预防压疮的效果观察[J].中国误诊学杂志,2011,11(35):8 639-8 640.
[8]刘双艳.康惠尔水胶体敷料用于压疮预防的效果观察[J].当代护士:中旬刊,2012(11):140-141.
[9]陈淑芳.康惠尔透明贴在降低骨科患者压疮发生率中的作用[J].中华全科医学,2012,10(4):650-651.
[10]曾斐.应用水胶体敷料预防中枢性高热患者压疮的效果评价[J].中国实用护理杂志,2012,28(30):70-71.
[11]代琳.软聚硅酮泡沫敷料在高危压疮患者预防压疮发生中的应用[J].中国医药导刊,2013,15(S1):215-216.
[12]SANTAMARIA N,GERDTZ M,SAGE S,et al. A randomised controlled trial of the effectiveness of soft silicone multilayered foam dressings in the prevention of sacral and heel pressure ulcers in trauma and critically ill patients:the border trial[J]. Int Wound J,2015,12(3):302-308.
[13]周红,郭小叶,宋雅莉,等.泡沫敷料与传统方法预防昏迷患者压疮的对比研究[J].中国医药指南,2014,12(3):73-74.
[14]李迎红,李艳.美皮康敷料在偏瘫病人中保护性预防压疮的好处或优点[J].今日健康,2014,13(7):254.
[15]胡玉兰,王维燕,马燕.美皮康敷料预防神经外科偏瘫患者压疮的护理观察[J].宁夏医学杂志,2014(8):760-761.
[16]王萍.康惠尔泡沫敷料预防脑卒中长期卧床患者压疮的效果观察[J].现代医药卫生,2015,31(S2):75-76.
[17]曹影.泡沫敷料在预防恶液质患者高危压疮护理中的应用[J].辽宁医学院学报,2015,36(6):101-102.
[18]SAAB I,SOLOMON J F,ALLEN L,et al. Hydrocellular foam is a cost-effective dressing for preventing pressure ulcers:a randomized controlled study[J]. J Am Coll Surgeons,2015,221(4):S114.
[19]杨少为,李娟.赛肤润液体敷料预防老年患者压疮的效果观察[J].临床合理用药杂志,2015,8(35):139-141.
[20]廖春燕.泡沫敷料在围术期高危压疮患者压疮预防中的应用[J].华夏医学,2016,29(2):100-103.
[21]KALOWES P,MESSINA V,LI M,et al. Five-layered soft silicone foam dressing to prevent pressure ulcers in the intensive care unit[J]. Am J Crit Care,2016,25(6):108-119.
[22]安敏.应用水胶体敷料预防癌症晚期患者发生压疮的护理体会[J].中国医药指南,2016,14(1):261.
[23]孙美玲,乐萍.泡沫敷料在高危患者压疮预防中的效果观察[J].当代护士:下旬刊,2016(9):119-120.
[24]金兰,李惠芬,王明婕.泡沫敷料预防恶病质病人高危压疮的效果观察[J].全科护理,2017,15(29):3 660-3 661.
[25]刘娜.泡沫敷料在高危患者压疮预防应用中的效果观察[J].临床医药文献杂志,2017,4(24):4 641-4 642.
[26]DUTRA R A,SALOME G M,ALVES J R,et al. Using transparent polyurethane film and hydrocolloid dressings to prevent pressure ulcers[J]. J Wound Care,2015,24(6):268,270-271,273-275.
[27]李志娜.对比各种敷料在神经科卧床患者压疮预防中的应用效果[J].实用临床护理学杂志,2017,2(34):71.
[28]VANDENKERKHOF E G,FRIEDBERG E,HARRISON M B.Prevalence and risk of pressure ulcers in acute care following implementation of practice guidelines:annual pressure ulcer prevalence census 1994-2008[J]. J Healthc Qual,2011,33(5):58-67.
[29]于美华,何丽云,谢玮娜,等.组合一体式俯卧体位垫的研制与应用[J].医疗卫生装备,2017,38(8):104-107.
[30]MCINNES E,JAMMALI-BLASI A,BELL-SYER S E. Support surfaces for pressure ulcer prevention[J]. Cochrane Database Syst Rev,2015,3(9):001735.
[31]张丽红,叶霞,车银凤.水胶体敷料预防压疮的中文文献Meta分析[J].四川医学,2016,37(11):1 245-1 247.
[32]黄蕾,刘立宝,胡爱玲.泡沫敷料预防高危风险患者压疮的Meta分析[J].护理学杂志,2014,29(12):75-78.
[33]陈丹,朱佳清,陆可儿,等.美皮康敷料预防无创通气压疮的Meta分析[J].浙江医学教育,2016,15(2):47-50,57.
[34]SUTTON A J,DUVAL S J,TWEEDIE R L,et al. Empirical assessment of effect of publication bias on meta-analyses[J].BMJ,2000,320(7 249):1 574-1 577.
[35]EGGER M,EBRAHIM S,SMITH G D. Where now for metaanalysis?[J]. Int J Epidemiol,2002,31(1):1-5.
[2]LYDER C H,WANG Y,METERSKY M,et al. Hospital-acquired pressure ulcers:results from the national Medicare Patient Safety Monitoring System study[J]. J Am Geriatr Soc,2012,60:1 603-1 608.
[3]SPILSBURY K,NELSON A,CULLUM N,et al. Pressure ulcers and their treatment and effects on quality of life:hospital inpatient perspectives[J]. J Adv Nurs,2007,57(5):494-504.
[4]TSCHANNEN D,BATES O,TALSMA A N,et al. Patientspecific and surgical characteristics in the development of pressure ulcers[J]. Am J Crit Care,2012,21(2):116-125.
[5]张珺,李荣科,陈可欣,等.敷料预防无创正压通气鼻面部压疮效果的网状Meta分析[J].护理学杂志,2016,31(2):102-106.
[6]田金徽,李伦,赵晔,等.网状Meta分析的撰写与报告[J].中国药物评价,2013,30(6):321-323,333.
[7]孙淮庆.软聚硅酮泡沫敷料预防压疮的效果观察[J].中国误诊学杂志,2011,11(35):8 639-8 640.
[8]刘双艳.康惠尔水胶体敷料用于压疮预防的效果观察[J].当代护士:中旬刊,2012(11):140-141.
[9]陈淑芳.康惠尔透明贴在降低骨科患者压疮发生率中的作用[J].中华全科医学,2012,10(4):650-651.
[10]曾斐.应用水胶体敷料预防中枢性高热患者压疮的效果评价[J].中国实用护理杂志,2012,28(30):70-71.
[11]代琳.软聚硅酮泡沫敷料在高危压疮患者预防压疮发生中的应用[J].中国医药导刊,2013,15(S1):215-216.
[12]SANTAMARIA N,GERDTZ M,SAGE S,et al. A randomised controlled trial of the effectiveness of soft silicone multilayered foam dressings in the prevention of sacral and heel pressure ulcers in trauma and critically ill patients:the border trial[J]. Int Wound J,2015,12(3):302-308.
[13]周红,郭小叶,宋雅莉,等.泡沫敷料与传统方法预防昏迷患者压疮的对比研究[J].中国医药指南,2014,12(3):73-74.
[14]李迎红,李艳.美皮康敷料在偏瘫病人中保护性预防压疮的好处或优点[J].今日健康,2014,13(7):254.
[15]胡玉兰,王维燕,马燕.美皮康敷料预防神经外科偏瘫患者压疮的护理观察[J].宁夏医学杂志,2014(8):760-761.
[16]王萍.康惠尔泡沫敷料预防脑卒中长期卧床患者压疮的效果观察[J].现代医药卫生,2015,31(S2):75-76.
[17]曹影.泡沫敷料在预防恶液质患者高危压疮护理中的应用[J].辽宁医学院学报,2015,36(6):101-102.
[18]SAAB I,SOLOMON J F,ALLEN L,et al. Hydrocellular foam is a cost-effective dressing for preventing pressure ulcers:a randomized controlled study[J]. J Am Coll Surgeons,2015,221(4):S114.
[19]杨少为,李娟.赛肤润液体敷料预防老年患者压疮的效果观察[J].临床合理用药杂志,2015,8(35):139-141.
[20]廖春燕.泡沫敷料在围术期高危压疮患者压疮预防中的应用[J].华夏医学,2016,29(2):100-103.
[21]KALOWES P,MESSINA V,LI M,et al. Five-layered soft silicone foam dressing to prevent pressure ulcers in the intensive care unit[J]. Am J Crit Care,2016,25(6):108-119.
[22]安敏.应用水胶体敷料预防癌症晚期患者发生压疮的护理体会[J].中国医药指南,2016,14(1):261.
[23]孙美玲,乐萍.泡沫敷料在高危患者压疮预防中的效果观察[J].当代护士:下旬刊,2016(9):119-120.
[24]金兰,李惠芬,王明婕.泡沫敷料预防恶病质病人高危压疮的效果观察[J].全科护理,2017,15(29):3 660-3 661.
[25]刘娜.泡沫敷料在高危患者压疮预防应用中的效果观察[J].临床医药文献杂志,2017,4(24):4 641-4 642.
[26]DUTRA R A,SALOME G M,ALVES J R,et al. Using transparent polyurethane film and hydrocolloid dressings to prevent pressure ulcers[J]. J Wound Care,2015,24(6):268,270-271,273-275.
[27]李志娜.对比各种敷料在神经科卧床患者压疮预防中的应用效果[J].实用临床护理学杂志,2017,2(34):71.
[28]VANDENKERKHOF E G,FRIEDBERG E,HARRISON M B.Prevalence and risk of pressure ulcers in acute care following implementation of practice guidelines:annual pressure ulcer prevalence census 1994-2008[J]. J Healthc Qual,2011,33(5):58-67.
[29]于美华,何丽云,谢玮娜,等.组合一体式俯卧体位垫的研制与应用[J].医疗卫生装备,2017,38(8):104-107.
[30]MCINNES E,JAMMALI-BLASI A,BELL-SYER S E. Support surfaces for pressure ulcer prevention[J]. Cochrane Database Syst Rev,2015,3(9):001735.
[31]张丽红,叶霞,车银凤.水胶体敷料预防压疮的中文文献Meta分析[J].四川医学,2016,37(11):1 245-1 247.
[32]黄蕾,刘立宝,胡爱玲.泡沫敷料预防高危风险患者压疮的Meta分析[J].护理学杂志,2014,29(12):75-78.
[33]陈丹,朱佳清,陆可儿,等.美皮康敷料预防无创通气压疮的Meta分析[J].浙江医学教育,2016,15(2):47-50,57.
[34]SUTTON A J,DUVAL S J,TWEEDIE R L,et al. Empirical assessment of effect of publication bias on meta-analyses[J].BMJ,2000,320(7 249):1 574-1 577.
[35]EGGER M,EBRAHIM S,SMITH G D. Where now for metaanalysis?[J]. Int J Epidemiol,2002,31(1):1-5.
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