Abstract:
Hyperbaric oxygen therapy (HBOT) has been used in patients with diabetic foot ulcers (DFU) for many years, but its clinical efficacy is still controversial. Therefore, this study explored the efficacy of HBOT applied to DFU by means of meta-analysis. PubMed, Cochrane Library, Embase, CNKI and Wanfang databases were searched, from database inception to October 2023, and published randomised controlled trials (RCTs) of HBOT in DFU were collected. Two investigators independently screened the collected literature, extracted relevant data and assessed the quality of the literature. Review Manager 5.4 software was applied for data analysis. Twenty-nine RCTs with 1764 patients were included. According to the combined results, when compared with conventional treatment, HBOT significantly increased the complete healing rate of DFUs (46.76% vs. 24.46%, odds ratio [OR]: 2.83, 95% CI: 2.29-3.51, p < 0.00001) and decreased the amputation rate (26.03% vs. 45.00%, OR: 0.41, 95% CI: 0.18-0.95, p = 0.04), but the incidence of adverse events was significantly higher in patients (17.37% vs. 8.27%, OR: 2.49, 95% CI: 1.35-4.57, p = 0.003), whereas there was no significant difference in the mortality (6.96% vs. 12.71%, OR: 0.52, 95% CI: 0.21-1.28, p = 0.16). Our results suggest that HBOT is effective in increasing the complete healing rate and decreasing the amputation rate in patients with DFUs, but increases the incidence of adverse events, while it has no significant effect on mortality.
摘要:
高压氧治疗(HBOT)已在糖尿病足溃疡(DFU)患者中应用多年,但其临床疗效仍存在争议。因此,本研究通过荟萃分析探讨HBOT应用于DFU的疗效。PubMed,科克伦图书馆,Embase,检索了CNKI和万方数据库,从数据库开始到2023年10月,我们收集了DFU中HBOT的已发表随机对照试验(RCT).两名研究者独立筛选收集的文献,提取相关数据并对文献质量进行评价。采用ReviewManager5.4软件进行数据分析。纳入了29个RCT,包括1764名患者。根据综合结果,与常规治疗相比,HBOT显着提高了DFU的完全治愈率(46.76%vs.24.46%,比值比[OR]:2.83,95%CI:2.29-3.51,p<0.00001),并降低截肢率(26.03%vs.45.00%,OR:0.41,95%CI:0.18-0.95,p=0.04),但患者的不良事件发生率明显较高(17.37%vs.8.27%,OR:2.49,95%CI:1.35-4.57,p=0.003),而死亡率无显著差异(6.96%vs.12.71%,OR:0.52,95%CI:0.21-1.28,p=0.16)。我们的结果表明,HBOT对提高DFU患者的完全治愈率和降低截肢率是有效的,但增加了不良事件的发生率,虽然对死亡率没有显著影响。