背景

当前有多种预防方法可用于治疗暴露性角膜病变。由于缺乏来自随机对照试验（RCT）的证据，目前尚不清楚这些预防方法在暴露性角膜病变患者中的相对作用。本研究目的是进行网状Meta分析，比较不同方法预防暴露性角膜病的功效，并对这些护理方法进行排序以供实际考虑。

方法

对MEDLINE（PubMed），EMBASE，Web of Science，CNKI，Weipu，万方数据库和China Biology Medicine光盘进行了文献检索。两位作者根据预先设计的Excel电子表格独立地从每个包含的RCT中提取数据，并使用Cochrane偏倚风险工具评估了包含的RCT的方法学质量。使用R（V.3.6.2）和Stata（V.15.0）分析数据。

结果

纳入21项RCT，涉及2,022例患者，并评估了11种预防方法。根据后验概率进行的排名显示，人工泪液可能是预防暴露性角膜病的最佳方法（35％），聚乙烯覆盖物可能是第二好（31％），游泳镜可能是第三好（21％），泡沫敷料可能排名第四（18％）。

结论

该网状Meta分析表明，可以选择人工泪液，聚乙烯覆盖物，泳镜和泡沫敷料来预防重症监护病房患者的暴露性角膜病，这在将来的研究中很重要。尽管证据不足，但应更加注意本领域最常用的预防方法的正面对比。

 

   

Background

There is a wide variety of preventive methods currently available for the treatment of exposure keratopathy. Because of a lack of evidence from head-to-head randomized controlled trials (RCTs), the relative effects of these preventive methods in exposure keratopathy patients remain unclear. The purpose of our study is to carry out a network meta-analysis comparing the efficacy of different methods for the prevention of exposure keratopathy and rank these nursing methods for practical consideration.

Methods

A literature search was performed of the MEDLINE (PubMed), EMBASE, Web of Science, China National Knowledge Infrastructure Library (CNKI), China Science and Technology Journal Database (Weipu), WanFang Database and China Biology Medicine disc. Two authors independently extracted data from each included RCTs according to a predesigned Excel spreadsheet and assessed the methodological quality of included RCTs using the Cochrane risk of bias tool. Data was analyzed using the R (V.3.6.2) and the Stata (V.15.0).

Results

21 RCTs involving 2,022 patients and evaluating 11 preventive methods were included. Rankings based on posterior probabilities revealed that artificial tear ointment might be the best way to prevent exposure keratopathy (35%), polyethylene covers might be the second-best (31%), swimming goggles might be the third-best (21%), foam dressing might be the fourth-best (18%).

Conclusions

This network meta-analysis indicated that artificial tear ointment, polyethylene covers, swimming goggles and foam dressing might be selected for the prevention of exposure keratopathy in intensive care unit patients, which is important in future research. Although evidence is scant, more attention should be paid to head-to-head comparisons of the most commonly used prevention methods in this field.

Keywords

Critical care

Eye care

Nursing

Exposure keratopathy

原文链接：

https://www.sciencedirect.com/science/article/abs/pii/S0020748921000663