Hyperbaric Oxygen Therapy for chronic diabetic foot ulcers: an Overview of Systematic Reviews.
Hyperbaric Oxygen Therapy for chronic diabetic foot ulcers: an Overview of Systematic Reviews.
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DOI：
10.1016/j.diabres.2021.108862
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发表时间：
2021-05
影响因子：
5.1
通讯作者：
Wenhui Li;Changgeng Fu;Xv Lei;Baozhong Yang;Guobin Liu;Weijing Fan
中科院分区：
文献类型：
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作者：
Wenhui Li;Changgeng Fu;Xv Lei;Baozhong Yang;Guobin Liu;Weijing Fan
目的高压氧治疗糖尿病足溃疡已在医学实践中广泛应用，但其临床效果尚不明确。方法计算机检索PubMed、科克伦图书馆、Web of Knowledge、Embase、MEDLINE、中国国家基础知识数据库、重庆维普数据库、中国生物医学数据库、万方数据库，检索日期为2020年12月1日。纳入评价高压氧治疗糖尿病足溃疡患者疗效的系统评价（SR）。使用AMSTAR-2工具评估纳入SR的方法学质量。使用GRADE评估主要研究的证据质量。使用PRISMA评估所包含SR的完整性。使用ROBIS评估工具评估每个SR的偏倚风险。根据AMSTAR-2的结果，只有1篇纳入的综述被评为高质量，6篇纳入的综述被评为中等质量。使用PRISMA，报告清单相对完整，但在方案和注册、检索策略和附加分析的主题中仍存在一些报告缺陷。根据ROBIS工具，只有5名工作人员代表/管理事务助理的偏倚风险较低。与GRADE系统，没有高质量的证据被发现，只有13个结果提供了中等质量的evidence.ConclusionsThere是有限的临床证据支持高压氧治疗糖尿病足溃疡的治疗，这是不建议常规高压氧治疗糖尿病足溃疡的所有患者，特别是那些非缺血性糖尿病足溃疡。高压氧治疗在促进缺血性糖尿病足溃疡患者溃疡愈合和降低截肢率方面具有一定的潜力，但由于支持这些结果的SR/MA质量低且数量少，因此在广泛推荐之前需要具有严格研究设计和更大样本的高质量研究。
ObjectivesHyperbaric oxygen therapy in the treatment of diabetic foot ulcer has been widely used in medical practice, but its clinical effect is not clear. The purpose of this overview of systematic reviews is to evaluate the clinical evidence of hyperbaric oxygen therapy in the treatment of diabetic foot ulcers.MethodsPubMed, Cochrane Library, Web of Knowledge, Embase, MEDLINE, Chinese National Knowledge Infrastructure Database, the Chongqing VIP Database, Chinese Biomedical Database, and Wanfang Database were searched in 1st December 2020. Systematic reviews (SRs) evaluating the effects of Hyperbaric oxygen therapy in people with diabetic foot ulcer were included. Methodological quality of the included SRs was assessed using the AMSTAR-2 tool. The quality of evidence of the primary studies was assessed using GRADE. The integrity of the included SRs was assessed using PRISMA. The bias risk of each SR was assessed using ROBIS evaluation tool.ResultsEleven SRs/MAs met all inclusion criteria. According to the results of the AMSTAR-2, only 1 included review were rated critically as being of high quality, 6 included review were rated critically as being of medium quality. With PRISMA, the reporting checklist was relatively complete, but some reporting weaknesses remained in the topics of the protocol and registration, search strategy, and additional analyses. Based on the ROBIS tool, only five SRs/MAs had a low risk of bias. With the GRADE system, no high-quality evidence was found, and only 13 outcomes provided moderate-quality evidence.ConclusionsThere is limited clinical evidence to support hyperbaric oxygen therapy in the treatment of diabetic foot ulcers, it is not recommended to routinely apply hyperbaric oxygen therapy to all patients with diabetic foot ulcers, especially those with non-ischemic diabetic foot ulcers. Hyperbaric oxygen therapy has certain potential to promote ulcer healing and reduce amputation rate in patients with ischemic diabetic foot ulcers, but due to the low quality and small quantity of the SRs/MAs supporting these results, high-quality studies with rigorous study designs and larger samples are needed before widespread recommendations can be made.