湿润烧伤膏外敷治疗压疮疗效的系统评价
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摘要
[目的]系统评价湿润烧伤膏外敷治疗压疮的临床疗效。[方法]计算机检索中国生物医学文献数据库(CBM)、中国知网全文数据库(CNKI)、万方数据库(WanFang)、维普数据库(VIP)、PubMed、EMbase以及The Cochrane Library数据库中应用湿润烧伤膏治疗压疮的随机对照试验。检索时限均从建库至2017年10月,根据纳入及排除标准筛选文献,应用RevMan5.3软件行Meta分析。[结果]共纳入14篇文献,涉及684例压疮病人,对照组给予常规治疗、护理,试验组在对照组基础上给予湿润烧伤膏外敷治疗。Meta分析结果显示,与常规治疗相比,外敷湿润烧伤膏可提高压疮治疗有效率[OR=5.88,95%CI(3.54,9.75),P<0.05],缩短压疮治愈时间[MD=-5.03,95%CI(-6.02,-4.03),P<0.05]。亚组分析结果显示,试验组治疗Ⅰ期、Ⅱ期压疮的有效率与对照组相比差异无统计学意义(P>0.05),但可提高Ⅲ期、Ⅳ期压疮病人的治疗有效率[OR=4.24,95%CI(1.56,11.50),P<0.05];合并结果显示湿润烧伤膏外敷厚度≤2.5 mm和≥4.0 mm均能提高压疮病人的治疗有效率[OR=8.52,95%CI(4.17,17.40),P<0.05;OR=12.38,95%CI(2.09,73.45),P<0.05]。[结论]湿润烧伤膏外敷治疗压疮有较好的临床疗效,可提高治疗有效率,缩短治愈时间,建议临床应用。
Objective:To systematically evaluate the clinical efficacy of external application of moist exposed burn ointment(MEBO) on the treatment of pressure ulcers.Methods:Literatures of randomized controlled trials(RCTs) for the application of MEBO in treating pressure ulcers were retrieved from the Chinese biomedical literature database(CBM),China Knowledge Network Full Text Database(CNKI),Wanfang database,VIP database,PubMed,EMbase and The Cochrane Library database,from the establishment of the library to October 2017.The literatures were enrolled according to the inclusion and exclusion criteria,and the RevMan 5.3 software was used for meta-analysis.Results: A total of 14 articles were included,involving 684 patients with pressure ulcers.The control group received routine treatment and nursing.The experimental group received the external application of MEBO based on the control group.Meta-analysis showed that external application of MEBO could improve the treatment efficiency of pressure ulcers compared with conventional treatment [OR=5.88,95%CI(3.54,9.75),P<0.05],and shorten the healing time of pressure ulcers[MD=-5.03,95%CI(-6.02,-4.03),P<0.05].Subgroup analysis showed that there was no significant difference between the experimental group and the control group in the treatment of stage Ⅰ and stage Ⅱ pressure ulcers [P>0.05],but it could improve the treatment efficiency of patients with stage Ⅲ and Ⅳ pressure sores[OR=4.24,95%CI(1.56,11.50),P<0.05].The combined results showed that the thickness of the external application of MEBO≤2.5 mm and≥4.0 mm could improve the treatment efficiency of patients with pressure ulcers[OR=8.52,95%CI(4.17,17.40),P<0.05;OR = 12.38,95%CI(2.09,73.45),P<0.05].Conclusions:External application of MEBO had a good clinical effect on treating pressure sores,which could improve the efficiency of treatment and shorten the healing time.So we recommend it for clinical application.
Objective:To systematically evaluate the clinical efficacy of external application of moist exposed burn ointment(MEBO) on the treatment of pressure ulcers.Methods:Literatures of randomized controlled trials(RCTs) for the application of MEBO in treating pressure ulcers were retrieved from the Chinese biomedical literature database(CBM),China Knowledge Network Full Text Database(CNKI),Wanfang database,VIP database,PubMed,EMbase and The Cochrane Library database,from the establishment of the library to October 2017.The literatures were enrolled according to the inclusion and exclusion criteria,and the RevMan 5.3 software was used for meta-analysis.Results: A total of 14 articles were included,involving 684 patients with pressure ulcers.The control group received routine treatment and nursing.The experimental group received the external application of MEBO based on the control group.Meta-analysis showed that external application of MEBO could improve the treatment efficiency of pressure ulcers compared with conventional treatment [OR=5.88,95%CI(3.54,9.75),P<0.05],and shorten the healing time of pressure ulcers[MD=-5.03,95%CI(-6.02,-4.03),P<0.05].Subgroup analysis showed that there was no significant difference between the experimental group and the control group in the treatment of stage Ⅰ and stage Ⅱ pressure ulcers [P>0.05],but it could improve the treatment efficiency of patients with stage Ⅲ and Ⅳ pressure sores[OR=4.24,95%CI(1.56,11.50),P<0.05].The combined results showed that the thickness of the external application of MEBO≤2.5 mm and≥4.0 mm could improve the treatment efficiency of patients with pressure ulcers[OR=8.52,95%CI(4.17,17.40),P<0.05;OR = 12.38,95%CI(2.09,73.45),P<0.05].Conclusions:External application of MEBO had a good clinical effect on treating pressure sores,which could improve the efficiency of treatment and shorten the healing time.So we recommend it for clinical application.
引文
[1] 邓欣,吕娟,陈佳丽,等.2016年最新压疮指南解读[J].华西医学,2016,31(9):1496-1498.
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[3] 徐玲,蒋琪霞.我国12所医院压疮现患率和医院内获得性压疮发生率调研[J].护理学报,2012,19(5A):9-13.
[4] Wound,Ostomy and Continence Nurses Society—Wound Guidelines Task Force.WOCN 2016 guideline for prevention and management of pressure injuries(ulcers)[J].Journal of Wound,Ostomy and Continence Nursing,2017,44(3):241-246.
[5] 陈振宇.湿润烧伤膏治疗压疮的临床疗效观察[J].中国烧伤创疡杂志,2015,27(3):184-186.
[6] 王淑军,陈生,廖继棠,等.湿润烧伤膏治疗Ⅱ期褥疮临床疗效观察[J].中国烧伤创疡杂志,2004,16(4):288-290.
[7] 蒲红英,程文丽,何菊芳.湿润烧伤膏治疗压疮有效性的系统评价[J].护理学杂志,2011,26(3):79-81.
[8] HIGGINS J P T,GREEN S.Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[A].London:The Cochrane Collaboration,2011.
[9] 施柳燕.湿润烧伤膏联合红外线照射治疗压疮的临床疗效观察[J].大家健康(学术版),2014,8(22):154-155.
[10] 李凤娟,李家芝,刘春红.不同方法治疗Ⅰ期和Ⅱ期压疮效果观察[J].护理研究,2013,27(12B):4049-4050.
[11] 张锡梅.美宝湿润烧伤膏用于压疮的疗效观察及护理[J].中外健康文摘,2013,10(16):286.
[12] 李予.美宝湿润烧伤膏治疗压疮的临床研究与护理[J].中国保健营养(中旬刊),2012(9):203.
[13] 张美花.湿润烧伤膏与一般方法治疗褥疮疗效对比分析[J].中国误诊学杂志,2011,11(34):8365.
[14] 饶福金.美宝湿润烧伤膏治疗精神病患者压疮的效果观察[J].中外健康文摘,2009,6(30):239-240.
[15] 关存芝,张林,唐桂梅,等.湿润烧伤膏治疗褥疮效果观察[J].牡丹江医学院学报,1993,14(2):122.
[16] LI W,MA Y,YANG Q,et al.Moist exposed burn ointment for treating pressure ulcers[J].Medicine,2017,96(29):e7582.
[17] 魏贤芹.中医治疗溃疡性结肠炎42例疗效观察[J].齐鲁护理杂志,2005,11(6):669.
[18] 余敏.湿润烧伤膏治疗压力性损伤患者疗效观察[J].临床医药文献电子杂志,2017,4(44):8686-8687.
[19] 李雨君,胡敏艳.湿润烧伤膏治疗压疮的临床观察及护理[J].临床合理用药杂志,2011,4(1B):44.
[20] 吴显荣.湿润烧伤膏治疗压疮40例护理观察[J].中国医药指南,2010,8(29):326-327.
[21] 王芝兰.湿润烧伤膏治疗压疮的临床观察[J].天津药学,2003,15(5):28-29.
[22] 徐嘉琦,何依宁,李节,等.龙血竭外敷治疗褥疮疗效与安全性的系统评价[J].中国循证医学杂志,2013,13(10):1236-1243.
[23] 王银花.芦荟凝胶治疗Ⅰ、Ⅱ期压疮的效果研究[D].贵阳:贵阳医学院,2015.
[24] 董兴刚,张敏,冯健,等.中药金疮油膏治疗难治性压疮临床疗效观察[J].中国中西医结合杂志,2017,37(2):155-159.
[25] 刘泽洲,陈亮,于志红,等.压疮的中医外治研究进展[J].北京中医药,2017,36(2):182-184.
[26] 朱登玲,姜阿利,王霞,等.湿润烧伤膏治疗157例压疮疗效观察[J].中国烧伤创疡杂志,2016,29(2):113-117.
[27] 肖摩.皮肤原位再生复原技术在烧伤系统治疗中的临床应用[J].中国烧伤创疡杂志,2010,22(4):258-274.
[28] 郑玉红.烧伤再生医学预防控制烧伤创面感染的临床研究[J].临床医学,2013,33(3):88-89.
[2] ROCKVILLE M.Preventing pressure ulcers in hospitals-a toolkit for improving quality of care[EB/OL].(2014-10-01)[2018-05-17].https://www.ahrq.gov/professionals/systems/.hospital/pressure-ulcertoolkit/index.html.
[3] 徐玲,蒋琪霞.我国12所医院压疮现患率和医院内获得性压疮发生率调研[J].护理学报,2012,19(5A):9-13.
[4] Wound,Ostomy and Continence Nurses Society—Wound Guidelines Task Force.WOCN 2016 guideline for prevention and management of pressure injuries(ulcers)[J].Journal of Wound,Ostomy and Continence Nursing,2017,44(3):241-246.
[5] 陈振宇.湿润烧伤膏治疗压疮的临床疗效观察[J].中国烧伤创疡杂志,2015,27(3):184-186.
[6] 王淑军,陈生,廖继棠,等.湿润烧伤膏治疗Ⅱ期褥疮临床疗效观察[J].中国烧伤创疡杂志,2004,16(4):288-290.
[7] 蒲红英,程文丽,何菊芳.湿润烧伤膏治疗压疮有效性的系统评价[J].护理学杂志,2011,26(3):79-81.
[8] HIGGINS J P T,GREEN S.Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[A].London:The Cochrane Collaboration,2011.
[9] 施柳燕.湿润烧伤膏联合红外线照射治疗压疮的临床疗效观察[J].大家健康(学术版),2014,8(22):154-155.
[10] 李凤娟,李家芝,刘春红.不同方法治疗Ⅰ期和Ⅱ期压疮效果观察[J].护理研究,2013,27(12B):4049-4050.
[11] 张锡梅.美宝湿润烧伤膏用于压疮的疗效观察及护理[J].中外健康文摘,2013,10(16):286.
[12] 李予.美宝湿润烧伤膏治疗压疮的临床研究与护理[J].中国保健营养(中旬刊),2012(9):203.
[13] 张美花.湿润烧伤膏与一般方法治疗褥疮疗效对比分析[J].中国误诊学杂志,2011,11(34):8365.
[14] 饶福金.美宝湿润烧伤膏治疗精神病患者压疮的效果观察[J].中外健康文摘,2009,6(30):239-240.
[15] 关存芝,张林,唐桂梅,等.湿润烧伤膏治疗褥疮效果观察[J].牡丹江医学院学报,1993,14(2):122.
[16] LI W,MA Y,YANG Q,et al.Moist exposed burn ointment for treating pressure ulcers[J].Medicine,2017,96(29):e7582.
[17] 魏贤芹.中医治疗溃疡性结肠炎42例疗效观察[J].齐鲁护理杂志,2005,11(6):669.
[18] 余敏.湿润烧伤膏治疗压力性损伤患者疗效观察[J].临床医药文献电子杂志,2017,4(44):8686-8687.
[19] 李雨君,胡敏艳.湿润烧伤膏治疗压疮的临床观察及护理[J].临床合理用药杂志,2011,4(1B):44.
[20] 吴显荣.湿润烧伤膏治疗压疮40例护理观察[J].中国医药指南,2010,8(29):326-327.
[21] 王芝兰.湿润烧伤膏治疗压疮的临床观察[J].天津药学,2003,15(5):28-29.
[22] 徐嘉琦,何依宁,李节,等.龙血竭外敷治疗褥疮疗效与安全性的系统评价[J].中国循证医学杂志,2013,13(10):1236-1243.
[23] 王银花.芦荟凝胶治疗Ⅰ、Ⅱ期压疮的效果研究[D].贵阳:贵阳医学院,2015.
[24] 董兴刚,张敏,冯健,等.中药金疮油膏治疗难治性压疮临床疗效观察[J].中国中西医结合杂志,2017,37(2):155-159.
[25] 刘泽洲,陈亮,于志红,等.压疮的中医外治研究进展[J].北京中医药,2017,36(2):182-184.
[26] 朱登玲,姜阿利,王霞,等.湿润烧伤膏治疗157例压疮疗效观察[J].中国烧伤创疡杂志,2016,29(2):113-117.
[27] 肖摩.皮肤原位再生复原技术在烧伤系统治疗中的临床应用[J].中国烧伤创疡杂志,2010,22(4):258-274.
[28] 郑玉红.烧伤再生医学预防控制烧伤创面感染的临床研究[J].临床医学,2013,33(3):88-89.