Girgis Beshoy, Duarte José Alberto
CIAFEL, Faculty of Sports, University of Porto, Portugal.
J Tissue Viability. 2018 Nov;27(4):274-284. doi: 10.1016/j.jtv.2018.08.003. Epub 2018 Aug 11.
This review was conducted to determine and quantify the efficacy of high-voltage monophasic pulsed current (HVMPC) in the treatment of stage II-IV pressure ulcers (PrUs), identify the details of HVMPC intervention parameters and the superior protocol, and ascertain other potential benefits and the safety of HVMPC intervention. Eleven studies, nine randomized controlled trials (RCTs) and two case series studies, matched the criteria and were included in the systematic review, whereas, only level 1 evidence RCTs were included in the meta-analysis. The percentage of wound surface area reduction per week was 12.39%; 95% CI, [10.43-14.37] for HVMPC plus standard wound care (SWC) and 6.96%; 95% CI, [5.56-8.38] for SWC alone or SWC plus sham HVMPC. The net effect of HVMPC was 5.4% per week (an increase of 78% greater than SWC alone or SWC plus sham HVMPC). Level 1, 2 and 4 evidence studies have consistently indicated that HVMPC plus SWC were more effective than SWC alone or SWC plus sham HVMPC in treating stage II-IV PrUs. Level 1 evidence studies showed that HVMPC intervention improved the healing of PrUs (reduced wound surface area), and combined with SWC, increased the probability of complete healing and almost eliminated the probability of worsening of healing. HVMPC intervention was shown to be relatively safe, with rare adverse reactions.
本综述旨在确定并量化高压单相脉冲电流（HVMPC）治疗II-IV期压疮（PrUs）的疗效，确定HVMPC干预参数的细节及最佳方案，并确定HVMPC干预的其他潜在益处和安全性。11项研究符合标准并纳入系统评价，其中9项为随机对照试验（RCT），2项为病例系列研究；而荟萃分析仅纳入1级证据的RCT。HVMPC联合标准伤口护理（SWC）组每周伤口表面积减少百分比为12.39%；95%置信区间为[10.43-14.37]，单纯SWC组或SWC联合假HVMPC组为6.96%；95%置信区间为[5.56-8.38]。HVMPC的净效应为每周5.4%（比单纯SWC组或SWC联合假HVMPC组高78%）。1级、2级和4级证据的研究一致表明，在治疗II-IV期PrUs方面，HVMPC联合SWC比单纯SWC或SWC联合假HVMPC更有效。1级证据的研究表明，HVMPC干预可促进PrUs愈合（减少伤口表面积），联合SWC可提高完全愈合的概率，几乎消除愈合恶化的概率。HVMPC干预显示相对安全，不良反应罕见。
