Palfreyman S J, Lochiel R, Michaels J A
Sheffield Vascular Institute, Northern General Hospital, UK.
Vasc Med. 1998;3(4):301-13. doi: 10.1177/1358836X9800300406.
The aim of the study was to determine the relative effectiveness of compression therapies used in the treatment of venous leg ulcers. Randomized controlled trials (RCT) were sought using a search strategy that aimed to identify relevant RCT by searching eight electronic databases (including Medline, Embase and CINHAL), conference proceedings and hand searching key journals. In addition, citations within papers were scrutinized to identify any relevant studies. Suitability for inclusion in this review was determined by a critical appraisal of key determinants of the quality of the trials. Trials that included patients of mixed ulcer aetiology were excluded unless the results of patients with venous disease were reported separately. Data was extracted independently by two reviewers and synthesized quantitatively and qualitatively. Losses to follow-up/withdrawals were assumed to be failures of treatment. A total of 132 articles were identified, and of these eight fulfilled the inclusion criteria. The remaining 126 trials were excluded due to trial design flaws, the inclusion of mixed/arterial aetiology ulcers or because they were non-RCT. Meta-analysis using a random-effects model showed the benefits of multi-layer and elastic compression bandages. It was concluded that more high-quality trials are required and that more emphasis should be placed on economic and quality of life data to try to ascertain the cost-effectiveness and utility of the treatment options available.
本研究的目的是确定用于治疗下肢静脉溃疡的压迫疗法的相对有效性。采用一种检索策略寻找随机对照试验（RCT），该策略旨在通过检索八个电子数据库（包括医学索引数据库、荷兰医学文摘数据库和护理学与健康领域数据库）、会议论文集以及手工检索关键期刊来识别相关的随机对照试验。此外，还仔细审查了论文中的参考文献以识别任何相关研究。通过对试验质量的关键决定因素进行严格评估来确定是否适合纳入本综述。除非分别报告患有静脉疾病患者的结果，否则排除纳入了混合溃疡病因患者的试验。由两名审查员独立提取数据，并进行定量和定性综合分析。随访失访/退出被视为治疗失败。共识别出132篇文章，其中8篇符合纳入标准。其余126项试验因试验设计缺陷、纳入了混合/动脉病因溃疡或因为它们不是随机对照试验而被排除。使用随机效应模型进行的荟萃分析显示了多层和弹性压迫绷带的益处。得出的结论是，需要更多高质量的试验，并且应该更加重视经济和生活质量数据，以试图确定现有治疗方案的成本效益和实用性。
