超声辅助清创术治疗糖尿病足溃疡的疗效和安全性：11 项随机对照试验的系统评价和荟萃分析。
Efficacy and safety of ultrasound-assisted wound debridement in the treatment of diabetic foot ulcers: a systematic review and meta-analysis of 11 randomized controlled trials.
机构信息
Department of Traditional Chinese Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Longhua Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
出版信息
Front Endocrinol (Lausanne). 2024 May 1;15:1393251. doi: 10.3389/fendo.2024.1393251. eCollection 2024.
OBJECTIVE
Research data suggests that ultrasound-assisted wound debridement (UAWD) can effectively promote the healing of diabetic foot ulcers (DFU). However, existing research is not consistent with this viewpoint. Therefore, we conducted this study to investigate the effect of UAWD on the healing of diabetic foot ulcers.
METHODS
From the establishment of the database to January 2024, we searched 8 databases to study the effectiveness and safety of UAWD in the treatment of DFU. Two authors independently screened the qualifications of the articles, while two authors extracted relevant data. Statistical analysis was conducted using Review Manager 5.4 and STATA 18.0 software.
RESULTS
A total of 11 randomized controlled studies were included, with 6 countries and 696 participants participating. Our findings showed that UAWD was associated with a significant benefit in healing rate (OR = 2.60, 95% CI: [1.67, 4.03], P < 0.0001, I 25%), wound healing time (MD = -11.94, 95% CI: [-23.65, -0.23], P = 0.05, I 99%), percentage reduction in wound size (MD = 14.2, 95% CI: [10.8, 17.6], P = 0.47, I 32%), effectiveness of treatment (OR = 10.3, 95% CI: [4.68, 22.66], P < 0.00001, I 0%). Moreover, UAWD did not cause any significant adverse reactions. However, there was no obvious difference in wound blood perfusion (MD = 0.25, 95% CI: [-0.01, 0.52], P = 0.06, I 90%), transcutaneous oxygen partial pressure (MD = 14.34, 95% CI: [-10.03, 38.71], P = 0.25, I 98%).
CONCLUSION
UAWD can significantly improve wound healing rate, shorten wound healing time, accelerate wound area reduction, and improve clinical treatment effectiveness without significant adverse reactions. Although there is no significant difference in transcutaneous oxygen pressure and wound blood flow perfusion between UAWD and SWC. So we look forward to more scientifically blinded, placebo-controlled, high-quality studies in the future, to enable researchers to obtain more complete and accurate analytical data, in order to improve the scientific and credibility of the evidence.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42024501198.
目的
研究数据表明，超声辅助清创术（UAWD）可有效促进糖尿病足溃疡（DFU）的愈合。然而，现有研究并不支持这一观点。因此，我们进行了这项研究，以探讨 UAWD 对糖尿病足溃疡愈合的影响。
方法
从数据库建立到 2024 年 1 月，我们检索了 8 个数据库，以研究 UAWD 治疗 DFU 的有效性和安全性。两位作者独立筛选文章的资格，而两位作者提取相关数据。使用 Review Manager 5.4 和 STATA 18.0 软件进行统计分析。
结果
共纳入 11 项随机对照研究，来自 6 个国家，共 696 名参与者。我们的研究结果表明，UAWD 在愈合率（OR = 2.60，95%CI：[1.67，4.03]，P < 0.0001，I 25%）、创面愈合时间（MD = -11.94，95%CI：[-23.65，-0.23]，P = 0.05，I 99%）、创面面积减少百分比（MD = 14.2，95%CI：[10.8，17.6]，P = 0.47，I 32%）和治疗效果（OR = 10.3，95%CI：[4.68，22.66]，P < 0.00001，I 0%）方面均具有显著获益，且 UAWD 未引起任何明显的不良反应。然而，UAWD 对创面血流灌注（MD = 0.25，95%CI：[-0.01，0.52]，P = 0.06，I 90%）和经皮氧分压（MD = 14.34，95%CI：[-10.03，38.71]，P = 0.25，I 98%）没有明显影响。
结论
UAWD 可显著提高创面愈合率，缩短创面愈合时间，加速创面面积减少，提高临床治疗效果，且无明显不良反应。虽然 UAWD 与 SWC 之间在经皮氧分压和创面血流灌注方面无显著差异。因此，我们期待未来有更多科学盲法、安慰剂对照、高质量的研究，使研究人员能够获得更完整、更准确的分析数据，从而提高证据的科学性和可信度。
系统综述注册
https://www.crd.york.ac.uk/prospero/，标识符 CRD42024501198。
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