未经授权:葡萄酒色斑(PWS)通常会引起美容效果和心理困扰。脉冲染料激光(PDL)和光动力疗法(PDT)是最常用的治疗方法。到目前为止,PDL仍然是治疗的“黄金标准”。然而,随着临床应用的增加,其缺点变得显而易见。PDT已被证明是PDL的替代品。PWS患者仍然缺乏关于PDT的足够证据来做出明智的治疗决定。
UNASSIGNED:本系统评价和荟萃分析的目的是评估PDT用于PWS的安全性和有效性。
未经评估:在线数据集,包括PubMed,Embase,WebofScience,还有Cochrane图书馆,搜索与荟萃分析相关的出版物。两名评审员分别评估了每项列出的研究中的偏倚风险。建议评估的分级,发展,和评估(GRADE)用于评估治疗和安全性结果。
UNASSIGNED:我们的搜索检索到740个命中,最终只纳入了26项研究。在纳入的26项研究中,3个是随机临床试验,23项为前瞻性或回顾性队列研究.根据收集的评估,在1~8.2次治疗后,达到60%改善的个体百分比估计为51.5%[95%置信区间(CI):38.7~64.1;I2=83.8%],≥75%改善为20.5%(95%CI:14.5~26.5;I2=78.2%)(GRADE评分:非常低).由于荟萃分析的统计多样性,进行了亚组评估以确定多样性的来源.收集的结果表明,PDT对提高PWS的医疗效果的影响在不同的治疗阶段是显著的,不同类型的年龄,PWS的不同位置,和不同类型的PWS。大多数患者出现疼痛和水肿。在17项研究中,有7.9-34.1%的患者存在色素沉着过度。光敏性皮炎,色素沉着减退,水泡,很少有疤痕报告,发病率为0-5.8%。
UNASSIGNED:根据目前的证据,推荐光动力疗法作为PWS的安全有效治疗方法。然而,我们的发现是基于低质量的证据.因此,有必要进行大规模和高质量的比较研究来支持这一结论。
UNASSIGNED: Port wine stains (PWS) often cause cosmetic effects and psychological distress. Pulsed dye lasers (PDL) and photodynamic therapy (PDT) are the most commonly used treatments. PDL is still the \"gold standard\" of therapy to date. However, its shortcomings have become apparent as clinical applications have increased. PDT has been proven as an alternative to PDL. Patients with PWS still lack enough evidence about PDT to make informed treatment decisions.
UNASSIGNED: The purpose of this systematic
review and meta-analysis was to assess the safety and effectiveness of PDT for PWS.
UNASSIGNED: The online datasets, comprising PubMed, Embase, Web of Science, and the Cochrane Library, were searched for meta-analysis-relevant publications. Two reviewers separately evaluated the risk of bias in each listed study. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the treatment and safety outcomes.
UNASSIGNED: Our search retrieved 740 hits and only 26 studies were finally included. Among the 26 studies included, 3 were randomized clinical trials, and 23 were prospective or retrospective cohort investigations. Based on a gathered assessment, the percentage of individuals achieving a 60% improvement was estimated to be 51.5% [95% confidence interval (CI): 38.7-64.1; I 2 = 83.8%] and a ≥75% improvement was 20.5% (95% CI: 14.5-26.5; I 2 = 78.2%) after 1-8.2 treatment sessions (GRADE score: very low). Due to the statistical diversity of the meta-analysis, a subgroup assessment was performed to determine the sources of diversity. The collected findings indicated that the impact of PDT on enhancing the medical effectiveness of PWS was significant in different treatment sessions, different types of ages, different locations of PWS, and different types of PWS. Pain and edema occurred in most patients. Hyperpigmentation was present in 7.9-34.1% of the patients in 17 studies. Photosensitive dermatitis, hypopigmentation, blister, and scar were infrequently reported, with 0-5.8% incidences.
UNASSIGNED: Photodynamic therapy is recommended as a safe and effective treatment for PWS based on the current evidence. However, our findings are based on poor-quality evidence. Therefore, comparative investigations of a large scale and high quality are necessary to support this conclusion.