Nelson E A, Mani R, Vowden K
University of Leeds, School of Healthcare, Baines Wing, Leeds, UK, LS2 9UT.
Cochrane Database Syst Rev. 2008 Apr 16(2):CD001899. doi: 10.1002/14651858.CD001899.pub2.
Intermittent pneumatic compression (IPC) is a mechanical method of delivering compression to swollen limbs that can be used to treat venous leg ulcers and limb swelling due to lymphoedema. This review analyses the evidence for the effectiveness of IPC as a treatment for venous leg ulcers.
To determine whether IPC increases the healing of venous leg ulcers. To determine the effects of IPC on health related quality of life of venous leg ulcer patients.
We searched the Cochrane Wounds Group Specialised Register (December 2007); the Cochrane Central Register of Controlled Trials (CENTRAL) - The Cochrane Library Issue 4, 2007; Ovid MEDLINE - 2006 to November Week 2 2007; Ovid EMBASE - 2006 to 2007 Week 49 and Ovid CINAHL - 2006 to December Week 1 2007.
Randomised controlled studies either comparing IPC with control (sham IPC or no IPC) or comparisons between IPC treatment regimens, in venous ulcer management were included.
Data extraction and assessment of study quality were undertaken by one author and checked by a second.
Seven randomised controlled trials (including 367 people in total) were identified. Only one trial reported both allocation concealment and blinded outcome assessment. In one trial (80 people) more ulcers healed with IPC than with dressings (62% vs 28%; p=0.002). Four trials compared IPC with compression against compression alone. The first of these trials (45 people) found increased ulcer healing with IPC plus compression than with compression alone (relative risk for healing 11.4, 95% Confidence Interval 1.6 to 82). The remaining three trials (122 people) found no evidence of a benefit for IPC plus compression compared with compression alone. One small trial (16 people) found no difference between IPC (without additional compression) and compression bandages alone. One trial compared different ways of delivering IPC (104 people) and found that rapid IPC healed more ulcers than slow IPC (86% vs 61%; log rank p=0.003).
AUTHORS' CONCLUSIONS: IPC may increase healing compared with no compression, but it is not clear whether it increases healing when added to treatment with bandages, or if it can be used instead of compression bandages. Rapid IPC was better than slow IPC in one trial. Further trials are required to determine whether IPC increases the healing of venous leg ulcers when used in modern practice where compression therapy is widely used.
间歇性气动压迫（IPC）是一种对肿胀肢体施加压迫的机械方法，可用于治疗腿部静脉溃疡和淋巴水肿引起的肢体肿胀。本综述分析了IPC作为治疗腿部静脉溃疡有效性的证据。
确定IPC是否能促进腿部静脉溃疡的愈合。确定IPC对腿部静脉溃疡患者健康相关生活质量的影响。
我们检索了Cochrane伤口小组专业注册库（2007年12月）；Cochrane对照试验中心注册库（CENTRAL）——《Cochrane图书馆》2007年第4期；Ovid MEDLINE——2006年至2007年11月第2周；Ovid EMBASE——2006年至2007年第49周以及Ovid CINAHL——2006年至2007年12月第1周。
纳入在静脉溃疡治疗中比较IPC与对照（假IPC或无IPC）的随机对照研究，或IPC治疗方案之间的比较研究。
由一位作者进行数据提取和研究质量评估，并由另一位作者进行核对。
共确定了7项随机对照试验（总共包括367人）。只有一项试验报告了分配隐藏和盲法结局评估。在一项试验（80人）中，接受IPC治疗的溃疡愈合数量多于接受敷料治疗的（62%对28%；p = 0.002）。四项试验比较了IPC联合压迫与单纯压迫。其中第一项试验（45人）发现，IPC联合压迫比单纯压迫能促进更多溃疡愈合（愈合的相对风险为11.4，95%置信区间为1.6至82）。其余三项试验（122人）未发现IPC联合压迫比单纯压迫有获益的证据。一项小型试验（16人）发现，IPC（无额外压迫）与单纯压迫绷带之间无差异。一项试验比较了不同的IPC实施方式（104人），发现快速IPC比慢速IPC能使更多溃疡愈合（86%对61%；对数秩检验p = 0.003）。
与无压迫相比，IPC可能促进愈合，但尚不清楚在绷带治疗基础上加用IPC是否能促进愈合，或者它是否可替代压迫绷带。在一项试验中，快速IPC比慢速IPC效果更好。需要进一步试验来确定在广泛应用压迫治疗的现代实践中，IPC用于治疗腿部静脉溃疡时是否能促进愈合。
