Huang Zehao, Wu Siyu, Yu Ting, Hu Ailing
School of Nursing, Sun Yat-sen University, Guangzhou, China.
The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Adv Wound Care (New Rochelle). 2021 Feb;10(2):103-112. doi: 10.1089/wound.2020.1169. Epub 2020 May 20.
The meta-analysis was performed to summarize the available evidence and assess the efficacy of telemedicine for patients with chronic wounds. PubMed, Embase, Web of Science, The Cochrane Library, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and VIP databases were electronically searched to identify eligible studies updated to February 2020 to collect randomized controlled trials regarding the efficacy of telemedicine for patients with chronic wounds. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of included studies with the Cochrane Handbook for Systematic Reviews of Interventions. A meta-analysis was performed using RevMan 5.3 and StataSE. Fourteen studies involving 1,926 patients were included in the meta-analysis. Compared with usual care, telemedicine intervention significantly improved wound healing rate (risk ratio [RR] = 1.44, confidence interval [95% CI] = 1.16-1.80, = 0.001) and reduced adverse events (RR = 0.52, 95% CI = 0.34-0.80, = 0.003). No significant differences were found between patients allocated to the telemedicine group or usual care group, in terms of the outcomes of healing time, change in wound size, or mortality. Telemedicine is an effective approach to promote chronic wound healing and reduce adverse events. The meta-analysis demonstrates that telemedicine may improve the healing rate and reduce adverse events for patients with chronic wounds. Because of the limited quality and quantity of the included studies, rigorous studies with adequate sample sizes are required to conclude with more confidence.
进行荟萃分析以总结现有证据，并评估远程医疗对慢性伤口患者的疗效。通过电子检索PubMed、Embase、Web of Science、Cochrane图书馆、中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据库和维普数据库，以识别截至2020年2月更新的合格研究，收集有关远程医疗对慢性伤口患者疗效的随机对照试验。两名研究者独立筛选文献、提取数据，并使用《Cochrane干预措施系统评价手册》评估纳入研究的偏倚风险。使用RevMan 5.3和StataSE进行荟萃分析。荟萃分析纳入了14项研究，涉及1926例患者。与常规护理相比，远程医疗干预显著提高了伤口愈合率（风险比[RR]=1.44，置信区间[95%CI]=1.16-1.80，P=0.001），并减少了不良事件（RR=0.52，95%CI=0.34-0.80，P=0.003）。在愈合时间、伤口大小变化或死亡率等结局方面，分配到远程医疗组或常规护理组的患者之间未发现显著差异。远程医疗是促进慢性伤口愈合和减少不良事件的有效方法。荟萃分析表明，远程医疗可能提高慢性伤口患者的愈合率并减少不良事件。由于纳入研究的质量和数量有限，需要进行样本量充足的严谨研究，以便更有把握地得出结论。
