高压氧作为治疗静脉溃疡的辅助手段:一项系统综述。

IF 0.7 4区 医学 Q4 PERIPHERAL VASCULAR DISEASE
Colum Keohane, Daniel Westby, Fiona C Nolan, Mark Twyford, Wael Tawfick, Stewart R Walsh
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引用次数: 1

摘要

背景:高压氧治疗(HBOT)在糖尿病创面中的应用已被广泛研究。尽管静脉功能不全是下肢溃疡最常见的原因,但关于使用HBOT治疗下肢静脉性溃疡(VLU)的证据相对较少。我们进行了一项系统回顾来评估和综合现有证据,以评估使用HBOT治疗的VLU患者是否比对照组具有更高的(i) VLU完全愈合率或(ii) VLU面积缩小率。方法:按照PRISMA指南,检索PubMed、Scopus和Embase数据库。在删除重复后,由两位作者筛选标题的相关性,然后是摘要,然后是全文手稿。数据摘自相关来源,包括一篇已发表的摘要。使用2号偏倚风险(rob2)和1号非随机研究偏倚风险(robins - 1)工具评估纳入研究的偏倚风险。结果:纳入6项研究。这些研究存在显著的异质性,没有标准对照干预、结果报告方法或随访时间。两项研究报告了12周的随访结果和溃疡完全愈合的汇总分析,结果显示HBOT与对照组之间溃疡完全愈合的结果OR为1.54 (95%CI = 0.50 -4.75) P = 0.4478,差异无统计学意义。在4项报告5-6周随访的研究中也发现了类似的无显著性结果;或5.39 (95%ci = 0.57 -259.57) p = 0.1136。所有研究均报告了VLU面积的变化,合并标准化平均差异为1.70 (95%CI = 0.60 ~ 2.79) P = 0.0024,表明HBOT在减少溃疡面积方面具有统计学意义。结论:已有证据表明HBOT对VLU的完全愈合无明显影响。在减少溃疡大小方面有统计学上显著的益处,尽管在没有溃疡愈合的情况下,其临床意义尚未确定。目前的证据并不能证明HBOT在VLU中的广泛应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Hyperbaric Oxygen as an Adjunct in the Treatment of Venous Ulcers: A Systematic Review.

Hyperbaric Oxygen as an Adjunct in the Treatment of Venous Ulcers: A Systematic Review.

Hyperbaric Oxygen as an Adjunct in the Treatment of Venous Ulcers: A Systematic Review.

Hyperbaric Oxygen as an Adjunct in the Treatment of Venous Ulcers: A Systematic Review.

Background: The use of Hyperbaric Oxygen Therapy (HBOT) in diabetic wounds has been studied extensively. Even though venous insufficiency is the most common cause of lower limb ulceration, there is comparatively little evidence regarding the use of HBOT for Venous Leg Ulcers (VLU). We performed a systematic-review to evaluate and synthesise available evidence, to evaluate whether patients with VLU, when treated with HBOT, had greater rates of (i) complete VLU healing or (ii) reduction in VLU area, than controls.

Methods: In keeping with PRISMA guidelines, database searches of PubMed, Scopus and Embase was performed. After removal of duplicates, titles were screened for relevance by two authors, then abstracts, and in turn full text manuscripts. Data were extracted from relevant sources including one published abstract. Included studies were assessed for risk of bias using the Risk of Bias 2 (RoB-2) and Risk Of Bias In Nonrandomized Studies (ROBINS-I) tools.

Results: Six studies were included. There was significant heterogeneity across the studies, with no standard control intervention, method of outcome reporting, or duration of follow up. Two studies reported 12 week follow up results and pooled analysis of complete ulcer healing showed no statistically significant difference between HBOT and controls for the outcome of complete ulcer healing OR 1.54 (95%CI = .50-4.75) P = .4478. A similar non-signifiacnt result was seen in four studies reporting 5-6 week follow up; OR 5.39 (95%CI = .57-259.57) P = .1136. Change in VLU area was reported in all studies, and pooled standardised mean difference was 1.70 (95%CI = .60 to 2.79) P = .0024, indicating a statistically significant benefit of HBOT in reducing ulcer area.

Conclusion: Existing evidence suggests that HBOT does not significantly affect complete healing of VLU. There is a statistically significant benefit in terms of reducing ulcer size, though in the absence of ulcer healing the clinical significance of this is not established. Current evidence does not justify widespread use of HBOT for VLU.

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来源期刊
Vascular and Endovascular Surgery
Vascular and Endovascular Surgery SURGERY-PERIPHERAL VASCULAR DISEASE
CiteScore
1.70
自引率
11.10%
发文量
132
审稿时长
4-8 weeks
期刊介绍: Vascular and Endovascular Surgery (VES) is a peer-reviewed journal that publishes information to guide vascular specialists in endovascular, surgical, and medical treatment of vascular disease. VES contains original scientific articles on vascular intervention, including new endovascular therapies for peripheral artery, aneurysm, carotid, and venous conditions. This journal is a member of the Committee on Publication Ethics (COPE).
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