开放创面的负压治疗与传统换药治疗疗效对比的Meta分析

目的：应用Meta分析的方法总结评价负压创面治疗（ negative pressure wound therapy，NPWT ）与传统换药对开放创面治疗的疗效。方法检索1993年1月至2013年12月，Cochrane database、Pub med、Embase、中国知网、万方数据库和中国科技期刊数据库，且配合手工检索相关领域的杂志，英文检索关键词：“negative pressure dressing”，“negative pressure therapy”，“negative pressure wound therapy”，“subatmospheric pressure dressing”，“subatmospheric pressure therapy”，“suction dressing”，“topical negative pressure”，“VAC”，“vacuum assisted closure” and “vacuum therapy”，“vacuum sealing”，“foam suction dressing”，“topical negative pressure”and“suction therapy”。中文检索关键词：“VSD”，“VAC”，“负压封闭引流”。纳入应用NPWT与传统换药治疗开放创面的随机对照研究，并应用Rvaman5.1进行Meta分析。结果通过筛选初检文献12214篇，依照纳入及排除标准，最终纳入18个研究（845例）。7个研究以慢性创面愈合时间为观察指标，结果 P＝0.008。P＜0.05，提示 NPWT 组愈合时间短于传统换药组；5个研究以急性创面经治疗后可以关闭创面时间为观察指标，结果P＝0.00001。P＜0.05，提示急性创面经治疗后 NPWT 组可早于传统换药组关闭创面；6个研究以创面大小的改变率为观察指标，结果 P＝0.04。P＜0.05，提示NPWT组创面缩小快于传统换药组。结论 NPWT治疗较传统换药在治疗开放创面存在优势，可缩短急慢性创面闭合时间及加快缩小创面。

A meta-analysis of negative pressure wound therapy versus traditional wound care for open wounds

Objective To apply the technique of meta-analysis to summarize and evaluate the effects of negative pressure wound therapy （ NPWT ） and traditional wound care for open wounds. Methods The data of NPWT versus traditional wound care for open wounds from January 1993 to December 2013 were retrieved. The databases included Cochrane database, Pubmed, Embase, China National Knowledge Internet （ CNKI ）, Wanfang Data and China scientiifc journal database, and manual searching of journals in the related ifelds was conducted. The English key words included“negative pressure dressing”,“negative pressure therapy”,“negative pressure wound therapy”,“subatmospheric pressure dressing”, “subatmospheric pressure therapy”, “suction dressing”, “topical negative pressure”,“VAC”,“vacuum assisted closure”,“vacuum therapy”,“vacuum sealing”,“foam suction dressing”,“topical negative pressure” and “suction therapy”. The Chinese key words included “VSD”, “VAC” and “vacuum sealing drainage”. The randomized and controlled trials were performed, in which the effects of NPWT and traditional wound care for open wounds were compared. The Rvaman 5.1 was used for meta-analysis. Results 12 214 literatures were initially reviewed after screening. According to the inclusion and exclusion criteria, 18 studies were brought into the review, including 845 patients. In 7 studies, the healing time of chronic wounds was taken as the observation indicator, and the results were statistically signiifcant （ P=0.008, P＆lt;0.05 ）. The healing time in the NPWT group was obviously shorter than that in the traditional wound care group. In 5 studies, the time to prepare acute wounds to be closed was taken as the observation indicator, and the results were statistically signiifcant （ P=0.00001, P＆lt;0.05 ）. The healing time of acute wounds in the NPWT group was obviously shorter than that in the traditional wound care group. In 6 studies,the change ratio of the wound area was taken as the observation indicator, and the results were statistically signiifcant （ P=0.04, P＆lt;0.05 ）. The reduction rate of the wound area was faster in the NPWT group than that in the traditional wound care group. Conclusions This study reveals that the NPWT is superior to the traditional wound care in the treatment of open wounds, with the advantages of shortened closure time of acute or chronic wounds and quickened reduction of the wound area.