中国循证医学杂志

中国循证医学杂志

不同减压装置预防手术压力性损伤的网状 Meta 分析

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目的 系统评价不同减压装置预防手术压力性损伤的效果。 方法 计算机检索 PubMed、The Cochrane Library、Web of Science、EMbase、CBM、CNKI、WanFang Data 和 VIP 中有关不同减压装置预防手术压力性损伤的随机对照试验(RCT),检索时限均为建库至 2017 年 12 月。由 2 名研究者独立进行文献筛选、资料提取并评价纳入研究的偏倚风险后,采用 R 3.5.0 软件 gemtc 程序包、JAGS 3.4.0 和 Stata 13.0 软件进行网状 Meta 分析。 结果 共纳入 20 个 RCTs,共 4 183 例患者。网状 Meta 分析结果显示,在预防手术压力性损伤方面,多单元脉动动态垫优于标准垫,凝胶垫优于海绵垫、标准垫和棉垫纱布,泡沫敷料优于凝胶垫,差异均有统计学意义。排序概率图结果提示,泡沫敷料是预防术中压力性损伤的较优方案。 结论 根据网状 Meta 分析结果和概率排序结果,泡沫敷料预防术中压力性损伤效果优于其他减压装置。

Objectives To systematically review the preventive effects of different pressure relief devices. Methods Databases including PubMed, The Cochrane Library, Web of Science, EMbase, CBM, CNKI, VIP and WanFang Data were searched to collect randomized control trials (RCTs) on the preventive effects of pressure relief devices for the surgical pressure sore from inception to December 2017. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Network meta-analysis was then performed using gemtc package of R 3.5.0 software, Stata 13.0 and JAGS 3.4.0 software. Results A total of 20 RCTs involving 4 183 patients were included. The network meta-analysis showed that micropulse dynamic pad was superior to standard pad. The gel pad was superior to sponge pad. The standard pad and cotton gauze pad. The foam dressing was superior to gel pad. All of the differences were statistically significant. The results of the ranking probability plot suggested foam dressing as an optimal resolution for preventing surgical pressure sore. Conclusions According to the network meta-analysis and rankings, foam dressing is superior to other decompression devices in preventing surgical pressure sores.

关键词: 手术压力性损伤; 减压装置; 敷料; 减压垫; 网状 Meta 分析

Key words: Intraoperative pressure sore; Decompression device; Dressing; Decompression pad; Network meta-analysis

引用本文: 姚丽, 丁楠楠, 杨丽平, 韩春彦, 蒋玲洁, 姜变通, 吴雨晨, 张彩云, 田金徽, 张志刚. 不同减压装置预防手术压力性损伤的网状 Meta 分析. 中国循证医学杂志, 2018, 18(10): 1086-1092. doi: 10.7507/1672-2531.201806070 复制

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