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血管体靶向血管成形术对糖尿病足保肢及伤口愈合是否有效?一项荟萃分析

Is Angiosome-Targeted Angioplasty Effective for Limb Salvage and Wound Healing in Diabetic Foot? : A Meta-Analysis.

作者信息

Chae Kum Ju, Shin Jin Yong

机构信息

Department of Radiology, Chonbuk National University Hospital, Jeonju, Korea.

Department of Plastic and Reconstructive Surgery, Chonbuk National University Hospital, Jeonju, Korea.

出版信息

PLoS One. 2016 Jul 21;11(7):e0159523. doi: 10.1371/journal.pone.0159523. eCollection 2016.

Abstract

PURPOSE

Given that the efficacy of employing angiosome-targeted angioplasty in the treatment of diabetic foot remains controversial, this study was conducted to examine its efficacy.

METHODS

We performed a systematic literature review and meta-analysis using core databases, extracting the treatment modality of angiosome-targeted angioplasty as the predictor variable, and limb salvage, wound healing, and revision rate as the outcome variables. We used the Newcastle-Ottawa Scale to assess the study quality, along with the Cochrane Risk of Bias Tool. We evaluated publication bias using a funnel plot.

RESULTS

The search strategy identified 518 publications. After screening these, we selected four articles for review. The meta-analysis revealed that overall limb salvage and wound healing rates were significantly higher (Odds ratio = 2.209, 3.290, p = 0.001, p<0.001) in patients who received angiosome-targeted angioplasty than in those who received nonangiosome-targeted angioplasty. The revision rate between the angiosome and nonangiosome groups was not significantly different (Odds ratio = 0.747, p = 0.314).

CONCLUSION

Although a further randomized controlled trial is required for confirmation, angiosome-targeted angioplasty in diabetic foot was more effective than nonangiosome-targeted angioplasty with respect to wound healing and limb salvage.

摘要

目的

鉴于血管体靶向血管成形术治疗糖尿病足的疗效仍存在争议,本研究旨在探讨其疗效。

方法

我们使用核心数据库进行了系统的文献综述和荟萃分析,提取血管体靶向血管成形术的治疗方式作为预测变量,保肢、伤口愈合和翻修率作为结果变量。我们使用纽卡斯尔-渥太华量表评估研究质量,并使用Cochrane偏倚风险工具。我们使用漏斗图评估发表偏倚。

结果

检索策略共识别出518篇出版物。筛选后,我们选择了4篇文章进行综述。荟萃分析显示,接受血管体靶向血管成形术的患者的总体保肢率和伤口愈合率显著高于接受非血管体靶向血管成形术的患者(优势比分别为2.209、3.290,p = 0.001,p<0.001)。血管体组和非血管体组之间的翻修率无显著差异(优势比 = 0.747,p = 0.314)。

结论

尽管需要进一步的随机对照试验来证实,但在伤口愈合和保肢方面,糖尿病足的血管体靶向血管成形术比非血管体靶向血管成形术更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a558/4956043/9cdb2da29cdd/pone.0159523.g001.jpg

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