超声清创联合负压封闭引流治疗糖尿病足溃疡的Meta分析与试验序贯分析OACSTPCD

Objective To systematically evaluate the effectiveness and safety of ultrasonic debridement combined with vacuum sealing drainage(VSD)for the treatment of diabetic foot ulcer(DFU).Methods Randomized controlled trials and cohort studies related to ultrasonic debridement combined with VSD for the treatment of DFU were enrolled by retrieving the databases such as China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP,PubMed,Web of Science,Embase,and The Cochrane Library.After literature screening for performing quality evaluation,the Stata/MP 17.0 software was used for Meta-analysis,and the TSA 0.9 software was used to perform trial sequential analysis.Results A total of 16 literature was enrolled,including 1413 DFU patients,therein there were 719 cases in the experiment group(ultrasonic debridement combined with VSD),and 694 cases in the control group(routine debridement combined with VSD).The results of Meta-analysis revealed that ultrasonic debridement combined with VSD exhibited superior total effective rate,Visual Analogue Scale(VAS)score,length of hospital stay,dressing change frequency,bacterial clearance rate,transcutaneous partial pressure of oxygen,and superior incidence rates of general adverse events and severe adverse events as compared with routine debridement combined with VSD(P＜0.05).The results of trial sequential analysis revealed that the research findings exert robustness.Conclusion Compared with routine debridement combined with VSD,ultrasonic debridement combined with VSD for the treatment of DFU can obtain higher total effective rate,and preferably ameliorate wound infection status and tissue oxygen supply,shorten length of hospital stay and dressing change frequency,exerting preferably overall safety.