自体富血小板凝胶治疗糖尿病足的Meta分析

发布时间：2018-04-26 11:16

本文选题：自体富血小板凝胶 + 糖尿病足　；参考：《重庆医科大学》2015年硕士论文

【摘要】：目的系统评价自体富血小板凝胶(Autologous platelet-rich gel, APG)用于治疗糖尿病足(Diabetic foot, DF)的临床疗效。方法根据检索策略全面检索PubMed、EMbase、The Cochrane Library、相关期刊论文、维普中文科技期刊全文数据库、中国生物医学文献数据库、万方数据库等。并手工检索相关会议记录、参考文献、学位论文,必要时与作者联系获取相关数据。由两名评价员按照纳入与排除标准独立筛查文献,纳入符合标准的APG治疗DF的随机对照试验(Randomized controlled trials, RCT),并应用Cochrane协作网推荐的文献质量评价标准,进行文献质量评价,数据提取。所得结果由评价员进行交叉核对,当意见不统一时,通过讨论或交由第三方决定。所获数据使用RevMan 5.3软件进行合并分析。结果共收集符合纳入与排除标准RCT15篇,均为APG与常规治疗对照,共包含722例患者。Meta分析结果显示：1.APG治疗DF与常规治疗相比,提高了溃疡愈合率(P0.00001)。2.亚组分析APG与常规治疗DF Wagner分级各级溃疡愈合率得出：APG治疗Wagner 1级溃疡溃疡愈合率与常规治疗无明显差异(P=0.13)；APG治疗Wagner 2级溃疡溃疡愈合率优于常规治疗组(P=0.01)；APG治疗Wagner 3级溃疡溃疡愈合率优于常规治疗组(P=0.003)。3.APG治疗DF与常规治疗相比,缩短了溃疡愈合时间(P0.00001)。4.亚组分析APG与常规治疗DF Wagner分级各级溃疡愈合时间得出：APG治疗Wagner 1级溃疡与常规治疗相比,缩短了溃疡愈合时间(P0.00001)；APG治疗Wagner 2级溃疡与常规治疗相比,缩短了溃疡愈合时间(P0.00001)；APG治疗Wagner 3级溃疡与常规治疗相比,缩短了溃疡愈合时间(P0.00001)。5.APG治疗在DF溃疡面积上优于常规治疗组。6.尚未发现与APG治疗相关的不良反应及并发症。7.APG治疗住院费用低于常规治疗,但需更多大样本临床研究予以证实。结论APG对于DF治疗与常规治疗相比,可提高溃疡愈合率,缩短愈合时间,降低住院费用,是一种新型的安全的有效的治疗DF方法。但对于Wagner 1级溃疡愈合率与常规治疗无明显差异。
[Abstract]:Objective to evaluate the clinical efficacy of autologous platelet-rich platelet-rich gelatin in the treatment of diabetic foot. Methods according to the retrieval strategy, the Cochrane Library, the full text database of Chinese periodicals, the full text database of Chinese scientific and technological journals, the database of Chinese biomedical literature, the database of Wanfang, etc. Manual retrieval of meeting records, references, degree papers and, if necessary, contact the author to obtain relevant data. According to the criteria of inclusion and exclusion, two evaluators screened the literature independently, and included random controlled trials (RCTs), random controlled trials (RCTs) that accord with the standard of APG treatment for DF. The literature quality evaluation criteria recommended by Cochrane Cooperative Network were used to evaluate the literature quality and extract the data. The results are cross-checked by the evaluator, and discussed or decided by a third party when opinions are inconsistent. The acquired data were analyzed by RevMan 5.3 software. Results A total of 722 cases of RCT15 were collected in accordance with the inclusion and exclusion criteria, all of which were compared with conventional therapy. The results of meta-analysis showed that 1. 1. Compared with conventional treatment, the healing rate of ulcer was increased (P 0.00001 路2). Subgroup analysis of APG and routine treatment of DF Wagner grade ulcer healing rate showed that there was no significant difference between Wagner grade 1 ulcer healing rate and conventional treatment. The healing rate of Wagner 2 grade ulcer was better than that of routine treatment group (P < 0. 01). The rate of Wagner grade 1 ulcer healing was better than that of routine treatment group. The rate of Wagner grade 1 ulcer healing was better than that of routine treatment group. The healing rate of grade 3 ulcer was better than that of routine treatment group. The healing time of ulcer was shortened (P 0.00001. 4). The subgroup analysis showed that the healing time of Wagner grade 1 ulcer treated by APG was shorter than that of conventional treatment. Compared with conventional treatment, the healing time of Wagner grade 2 ulcer was shortened by APG. The results showed that compared with conventional treatment, the healing time of Wagner grade 1 ulcer was shortened. The healing time of Wagner grade 1 ulcer was significantly shorter than that of routine therapy. Compared with conventional treatment, the healing time of Wagner 3 ulcers was shortened (P 0.00001). 5. APG treatment was superior to the conventional treatment group in the area of DF ulcer. No adverse reactions and complications associated with APG treatment have been found. 7. APG-related hospitalization costs are lower than those of conventional therapy, but more large clinical studies are needed to confirm them. Conclusion compared with conventional treatment, APG can improve the healing rate, shorten the healing time and reduce the cost of hospitalization. It is a new safe and effective method to treat DF. However, there was no significant difference between Wagner grade 1 ulcer healing rate and routine treatment.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.2

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