软聚硅酮泡沫敷料治疗放射性皮炎的Meta分析
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摘要
背景:软聚硅酮泡沫敷料由软聚硅酮伤口接触层、聚氨酯泡沫吸收层和透气并防水的外覆薄膜3层组成,不仅有利于快速的肉芽组织生长,而且为伤口愈合提供了良好的湿性环境。目的:评价软聚硅酮泡沫敷料治疗放射性皮炎的效果。方法:应用计算机检索PubMed、Embase、Cochrane、中国学术期刊全文数据库、中国生物医学文献光盘数据库、万方数据平台和中文科技期刊数据库中关于软聚硅酮泡沫敷料应用于放射性皮炎的随机对照试验,检索时间均为建库至2018年10月。由2名研究生独立进行文献筛选、质量评价和资料提取。采用Revman5.3软件进行数据分析。结果与结论:共纳入6篇中文文献,包括416例放射性皮炎患者,其中观察组采用软聚硅酮泡沫敷料干预,对照组采用传统敷料、湿润烧伤膏和羊毛脂软膏中的一种进行干预。Meta分析结果显示:观察组放射性皮炎愈合时间短于对照组[MD=-6.36,95%CI(-8.72,-4.00),Z=5.28,P <0.000 01],放射性皮炎愈合率高于对照组[OR=5.67,95%CI(1.74,18.41),Z=2.89,P=0.004]。结果表明,软聚硅酮泡沫敷料应用于放射性皮炎的治疗效果优于其他敷料。
BACKGROUND: Soft silicone foam dressing is made up of 3 layers: soft silicone wound contact layer,polyurethane foam absorbing layer and breathable and waterproof outer covering film. It not only facilitates granulation tissue growth, but also provides a good wet environment for wound healing.OBJECTIVE: To evaluate the efficacy of soft silicone foam dressing in the treatment of radiation dermatitis.METHODS: Randomized controlled trials regarding soft silicone foam dressing applied to radiation dermatitis were searched by computer in PubMed, EMBASE, Cochrane, China Academic Journals Full-text Database,Chinese Biomedical Literature Database, Wanfang database and Chinese Science and Technology Periodicals Database.The retrieval time was limited to the period from database foundation to October 2018. Literature screening, quality evaluation and data extraction were conducted independently by two postgraduates. Revman 5.3 software was used for data analysis.RESULTS AND CONCLUSION: Six Chinese literatures were included, including 416 patients with radiation dermatitis. The experimental group was treated with soft silicone foam dressing, while the control group was treated with traditional dressing, moist exposed burn ointment or lanolin ointment. Meta-analysis results showed that the healing time of radiation dermatitis in the experimental group was shorter than that in the control group [MD=-6.36, 95%CI(-8.72,-4.00), Z=5.28, P < 0.000 01]. The healing rate of radiation dermatitis in the experimental group was significantly higher than that in the control group [OR=5.67, 95%CI(1.74, 18.41), Z=2.89, P=0.004]. The results suggest that soft silicone foam dressing exhibits better therapeutic effects on radiation dermatitis than other dressings.
BACKGROUND: Soft silicone foam dressing is made up of 3 layers: soft silicone wound contact layer,polyurethane foam absorbing layer and breathable and waterproof outer covering film. It not only facilitates granulation tissue growth, but also provides a good wet environment for wound healing.OBJECTIVE: To evaluate the efficacy of soft silicone foam dressing in the treatment of radiation dermatitis.METHODS: Randomized controlled trials regarding soft silicone foam dressing applied to radiation dermatitis were searched by computer in PubMed, EMBASE, Cochrane, China Academic Journals Full-text Database,Chinese Biomedical Literature Database, Wanfang database and Chinese Science and Technology Periodicals Database.The retrieval time was limited to the period from database foundation to October 2018. Literature screening, quality evaluation and data extraction were conducted independently by two postgraduates. Revman 5.3 software was used for data analysis.RESULTS AND CONCLUSION: Six Chinese literatures were included, including 416 patients with radiation dermatitis. The experimental group was treated with soft silicone foam dressing, while the control group was treated with traditional dressing, moist exposed burn ointment or lanolin ointment. Meta-analysis results showed that the healing time of radiation dermatitis in the experimental group was shorter than that in the control group [MD=-6.36, 95%CI(-8.72,-4.00), Z=5.28, P < 0.000 01]. The healing rate of radiation dermatitis in the experimental group was significantly higher than that in the control group [OR=5.67, 95%CI(1.74, 18.41), Z=2.89, P=0.004]. The results suggest that soft silicone foam dressing exhibits better therapeutic effects on radiation dermatitis than other dressings.
引文
[1]冯惠霞,郑素芬,祁丽萍,等.医用射线防护喷剂预防鼻咽癌放射性皮炎的临床观察及护理[J].中国肿瘤外科杂志,2018,10(2):135-136.
[2]丁晔.鼻咽癌放射性皮炎的临床治疗及护理进展[J].护士进修杂志,2017,32(1):24-27.
[3]Spalek M.Chronic radiation-induced dermatitis:Challenges and solutions.Clin Cosmet Investig Dermatol.2016;9:473-482.
[4]马丽,郦娜.不同皮肤射线防护剂对鼻咽癌调强放疗放射性皮炎的防护疗效及患者生活质量的影响[J].护理实践与研究,2016,13(18):13-15.
[5]王少芳,王慧璇,李巧春.干预在放射治疗引起放射性皮炎中的应用[J].世界最新医学信息文摘,2015,15(44):233-233.
[6]焦迎春,常晓畅,黄仙芝,等.新型软聚硅酮泡沫敷料治疗放射性皮炎的效果观察[J].护理研究:中旬版,2010,24(5):1282-1283.
[7]张冬英,蓝翔,樊慧红,等.放射治疗并发放射性皮炎防治的研究进展[J].中国现代医生,2017,55(27):166-168.
[8]辜梦聃,曾元丽,石小兰.放射治疗所致放射性皮炎防治及护理进展[J].现代临床护理,2017,16(5):65-71.
[9]王彤华,周雄丽,谢利勤,等.湿性敷料在伤口护理中的应用进展[J].齐齐哈尔医学院学报,2016,37(24):3078-3079.
[10]贺丽,韩伟,吴江文,等.湿性敷料治疗在各种创面治疗中的应用进展[J].兵团医学,2017,34(4):51-55.
[11]凃桂红,许春娇,朱贝贝.软聚硅酮泡沫敷料在放射性湿性皮炎中的临床应用[J].护理研究,2011,25(9):2510-2511.
[12]王芳,金丽芬,戴艺,等.美皮康敷料治疗鼻咽癌放疗患者放射性皮炎的效果[J].国际护理学杂志,2016,35(13):1869-1871.
[13]曾娟.美皮康治疗放射性皮炎的疗效观察及护理[J].全科护理,2011,9(24):2179-2180.
[14]贾雪梅,叶玉凤,熊小丽.泡沫型敷料治疗放射性皮炎的临床应用[J].医学信息,2015,28(28):352.
[15]蔡霜,蔡琪琳,杨少芳,等.新型软聚硅酮敷料在Ⅲ级放射性湿性皮炎中的临床研究[J].中华现代护理杂志,2009,15(22):2210-2211.
[16]蒋妙芬.应用新型软聚硅酮敷料治疗放射性皮炎的疗效观察[J].中国中医药咨讯,2010,2(9):66-66.
[17]蔡蕴敏,戚晓霞,陆慰英.自粘性泡沫敷料治疗乳腺癌患者放射性皮炎的疗效观察[J].中国临床医学,2015,22(3):401-402.
[18]辜梦聃,曾元丽,石小兰.放射治疗所致放射性皮炎防治及护理进展[J].现代临床护理,2017,13(5):69-75.
[19]万永慧,罗静,褚玉新,等.放射性皮炎的临床分级与护理[J].护士进修杂志,2016,31(8):737-739.
[20]陈敏.乳腺癌放射性皮炎的护理[J].饮食保健,2016,3(9):103.
[21]吴春艳,王林娟,张平.放射治疗致皮肤损伤的防治及护理[J].现代中西医结合杂志,2013,22(6):680-682.
[22]谷铣之,殷蔚伯.肿瘤放射治疗学[M].北京:北京医科大学中国协和医科大学联合出版社,2002:1108.
[23]黄娜.“壳聚糖”敷料膜加康复新治疗压疮的疗效观察[J].中外健康文摘,2011,8(25):221.
[24]张君丽,江旭丽,毛美君,等.蛋清治疗急性放射性湿性皮炎临床观察[J].中国高等医学教育,2011,26(6):137,140.
[25]唐菊花,朱艳仪,廖志伟,等.藻酸盐治疗Ⅲ度放射性皮炎的疗效观察[J].中国医学创新,2012,5(4):124-125.
[26]李峥,刘娜.不同换药法联合比亚芬加吹氧治疗放射性皮炎的疗效观察[J].护士进修杂志,2016,31(21):1965-1967.
[27]齐丽,徐嘉琪,杨立群,等.干性愈合与湿性愈合理论治疗压疮的比较研究[J].中国实用医药,2009,4(22):192-193.
[28]宁强华,陈得一,唐华丽,等.湿性愈合理论在治疗压疮中的临床疗效观察[J].检验医学与临床,2014,11(9):1269-1270.
[29]邢昌兰,段小芳,刘青,等.湿性愈合理论在压疮治疗中的应用[J].山西医药杂志,2015,44(6):713-714.
[30]陈影洁,吴伟英,黄剑施,等.湿性愈合理论在糖尿病足溃疡创面换药中的应用效果[J].护理实践与研究,2012,9(23):126-127.
[31]文笑明,李献成,徐美军.美皮康治疗Ⅵ期压疮的临床研究[J].全科护理,2010,8(3B):694-695.
[32]慧凤,鞠蓓蓓,王红萍.湿性愈合理论在临床压疮治疗中应用的研究进展[J].解放军护理杂志,2008,25(3A):42.
[33]程菁.伤口床准备原则在Ⅲ级急性放射性皮炎患者护理中的应用[J].中国保健营养,2015,25(15):167.
[34]黄燕,熊淑玲,罗志强,等.康复新与美宝烧伤膏在鼻咽癌患者急性放射性皮炎治疗中的效果评价[J].护理实践与研究,2016,13(23):60-61.
[35]陈三妹.鼻咽癌放射治疗患者颈部皮肤护理干预效果比较[J].中华护理杂志,2013,48(6):542-545.
[2]丁晔.鼻咽癌放射性皮炎的临床治疗及护理进展[J].护士进修杂志,2017,32(1):24-27.
[3]Spalek M.Chronic radiation-induced dermatitis:Challenges and solutions.Clin Cosmet Investig Dermatol.2016;9:473-482.
[4]马丽,郦娜.不同皮肤射线防护剂对鼻咽癌调强放疗放射性皮炎的防护疗效及患者生活质量的影响[J].护理实践与研究,2016,13(18):13-15.
[5]王少芳,王慧璇,李巧春.干预在放射治疗引起放射性皮炎中的应用[J].世界最新医学信息文摘,2015,15(44):233-233.
[6]焦迎春,常晓畅,黄仙芝,等.新型软聚硅酮泡沫敷料治疗放射性皮炎的效果观察[J].护理研究:中旬版,2010,24(5):1282-1283.
[7]张冬英,蓝翔,樊慧红,等.放射治疗并发放射性皮炎防治的研究进展[J].中国现代医生,2017,55(27):166-168.
[8]辜梦聃,曾元丽,石小兰.放射治疗所致放射性皮炎防治及护理进展[J].现代临床护理,2017,16(5):65-71.
[9]王彤华,周雄丽,谢利勤,等.湿性敷料在伤口护理中的应用进展[J].齐齐哈尔医学院学报,2016,37(24):3078-3079.
[10]贺丽,韩伟,吴江文,等.湿性敷料治疗在各种创面治疗中的应用进展[J].兵团医学,2017,34(4):51-55.
[11]凃桂红,许春娇,朱贝贝.软聚硅酮泡沫敷料在放射性湿性皮炎中的临床应用[J].护理研究,2011,25(9):2510-2511.
[12]王芳,金丽芬,戴艺,等.美皮康敷料治疗鼻咽癌放疗患者放射性皮炎的效果[J].国际护理学杂志,2016,35(13):1869-1871.
[13]曾娟.美皮康治疗放射性皮炎的疗效观察及护理[J].全科护理,2011,9(24):2179-2180.
[14]贾雪梅,叶玉凤,熊小丽.泡沫型敷料治疗放射性皮炎的临床应用[J].医学信息,2015,28(28):352.
[15]蔡霜,蔡琪琳,杨少芳,等.新型软聚硅酮敷料在Ⅲ级放射性湿性皮炎中的临床研究[J].中华现代护理杂志,2009,15(22):2210-2211.
[16]蒋妙芬.应用新型软聚硅酮敷料治疗放射性皮炎的疗效观察[J].中国中医药咨讯,2010,2(9):66-66.
[17]蔡蕴敏,戚晓霞,陆慰英.自粘性泡沫敷料治疗乳腺癌患者放射性皮炎的疗效观察[J].中国临床医学,2015,22(3):401-402.
[18]辜梦聃,曾元丽,石小兰.放射治疗所致放射性皮炎防治及护理进展[J].现代临床护理,2017,13(5):69-75.
[19]万永慧,罗静,褚玉新,等.放射性皮炎的临床分级与护理[J].护士进修杂志,2016,31(8):737-739.
[20]陈敏.乳腺癌放射性皮炎的护理[J].饮食保健,2016,3(9):103.
[21]吴春艳,王林娟,张平.放射治疗致皮肤损伤的防治及护理[J].现代中西医结合杂志,2013,22(6):680-682.
[22]谷铣之,殷蔚伯.肿瘤放射治疗学[M].北京:北京医科大学中国协和医科大学联合出版社,2002:1108.
[23]黄娜.“壳聚糖”敷料膜加康复新治疗压疮的疗效观察[J].中外健康文摘,2011,8(25):221.
[24]张君丽,江旭丽,毛美君,等.蛋清治疗急性放射性湿性皮炎临床观察[J].中国高等医学教育,2011,26(6):137,140.
[25]唐菊花,朱艳仪,廖志伟,等.藻酸盐治疗Ⅲ度放射性皮炎的疗效观察[J].中国医学创新,2012,5(4):124-125.
[26]李峥,刘娜.不同换药法联合比亚芬加吹氧治疗放射性皮炎的疗效观察[J].护士进修杂志,2016,31(21):1965-1967.
[27]齐丽,徐嘉琪,杨立群,等.干性愈合与湿性愈合理论治疗压疮的比较研究[J].中国实用医药,2009,4(22):192-193.
[28]宁强华,陈得一,唐华丽,等.湿性愈合理论在治疗压疮中的临床疗效观察[J].检验医学与临床,2014,11(9):1269-1270.
[29]邢昌兰,段小芳,刘青,等.湿性愈合理论在压疮治疗中的应用[J].山西医药杂志,2015,44(6):713-714.
[30]陈影洁,吴伟英,黄剑施,等.湿性愈合理论在糖尿病足溃疡创面换药中的应用效果[J].护理实践与研究,2012,9(23):126-127.
[31]文笑明,李献成,徐美军.美皮康治疗Ⅵ期压疮的临床研究[J].全科护理,2010,8(3B):694-695.
[32]慧凤,鞠蓓蓓,王红萍.湿性愈合理论在临床压疮治疗中应用的研究进展[J].解放军护理杂志,2008,25(3A):42.
[33]程菁.伤口床准备原则在Ⅲ级急性放射性皮炎患者护理中的应用[J].中国保健营养,2015,25(15):167.
[34]黄燕,熊淑玲,罗志强,等.康复新与美宝烧伤膏在鼻咽癌患者急性放射性皮炎治疗中的效果评价[J].护理实践与研究,2016,13(23):60-61.
[35]陈三妹.鼻咽癌放射治疗患者颈部皮肤护理干预效果比较[J].中华护理杂志,2013,48(6):542-545.