Fletcher A, Cullum N, Sheldon T A
NHS Centre for Reviews and Dissemination, University of York.
BMJ. 1997 Sep 6;315(7108):576-80. doi: 10.1136/bmj.315.7108.576.
To estimate the clinical and cost effectiveness of compression systems for treating venous leg ulcers.
Systematic review of research. Search of 19 electronic databases including Medline, CINAHL, and Embase. Relevant journals and conference proceedings were hand searched and experts were consulted.
Rate of healing and proportion of ulcers healed within a time period.
Randomised controlled trials, published or unpublished, with no restriction on date or language, that evaluated compression as a treatment for venous leg ulcers.
24 randomised controlled trials were included in the review. The research evidence was quite weak: many trials had inadequate sample size and generally poor methodology. Compression seems to increase healing rates. Various high compression regimens are more effective than low compression. Few trials have compared the effectiveness of different high compression systems.
Compression systems improve the healing of venous leg ulcers and should be used routinely in uncomplicated venous ulcers. Insufficient reliable evidence exists to indicate which system is the most effective. More good quality randomised controlled trials in association with economic evaluations are needed, to ascertain the most cost effective system for treating venous leg ulcers.
评估用于治疗下肢静脉性溃疡的加压系统的临床效果及成本效益。
进行系统性研究回顾。检索19个电子数据库，包括医学索引数据库（Medline）、护理学与健康领域数据库（CINAHL）及荷兰医学文摘数据库（Embase）。对相关期刊及会议论文集进行手工检索，并咨询专家。
愈合率及在一定时间段内溃疡愈合的比例。
纳入已发表或未发表的随机对照试验，对日期及语言无限制，评估加压作为下肢静脉性溃疡治疗方法的研究。
该综述纳入了24项随机对照试验。研究证据相当薄弱：许多试验样本量不足且方法普遍欠佳。加压似乎能提高愈合率。各种高压力方案比低压力方案更有效。很少有试验比较不同高压力系统的有效性。
加压系统可促进下肢静脉性溃疡的愈合，应常规用于无并发症的静脉性溃疡。尚无足够可靠的证据表明哪种系统最有效。需要更多高质量随机对照试验并结合经济评估，以确定治疗下肢静脉性溃疡最具成本效益的系统。
