1、CWs群体发病率在1-2%左右 DM发病专率5.6 15%DM出现DFU 10-14.5%DFU截肢 截肢后月内死亡10%CEs最低费用达到6000美元;全球费用负担每年130-150亿美元 临床上比较常见的慢性伤口类型 静脉瘀滞性溃疡;动脉溃疡;糖尿病足部溃疡;压力性溃疡（压疮）;烧伤后溃疡；脉管炎;坏疽性脓皮症;放射性皮损临床治疗慢性伤口的原则 创面局部保持湿润和伤口尽早封闭；防止细菌滋生和局部感染；清创（伤口床准备）；辅助治疗辅助治疗加压局部负压装置生长因子皮肤替代品高压氧治疗干细胞中药维A酸己酮可可碱生长因子细胞生长抑制因子上皮细胞生长因子成纤维细胞生长因子血小板衍生生长因子转化生长因
2、子胰岛素样生长因子白介素临床常用的包扎敷料 纱布敷料（Gauzes）；薄膜敷料（Films）；水凝胶敷料（Hydro els）；水胶 敷料（Hydro olloids）； 酸 敷料（Al i a es）； 敷料（Foams）；胶 白敷料（ olla e s）； 菌 （A imi ro ials） 第一部分组织工程皮肤治疗糖尿病足溃疡的Meta分析 目的：分析TES治疗DFU的随机对照试验，效果与效益。 方法：计算机检索Cochrane图书馆、Pubmed、EMbase、CBMWeb、CNKI、VIP，手工检索有关引用文献，收集以TES为干预措施治疗DFU的RCT，评价纳入研究的方法学质量并提取
3、有效数据进行Meta分析。 纳入7个，共880名患者，多中心研究6个。 No.Author Randomization Blinding Concealment Withdrawal ITT Quality level1 Gray DG 1996 10 Adequate Si- Blind Adequate Described Yes A2 Richard AP 1997 11 Unclear Si- Blind Adequate Described Yes A3 Aristidis V 2001 12 Adequate Not use Unclear Described Yes B4 Jas
4、on RH 2002 13 Adequate Si- Blind Adequate Not- descri Yes A5 Hunter HS 2002 14 Adequate Not use Adequate Described Yes A6 Carlo C 2003 15 Adequate Si- Blind Unclear Described Yes A7 William AM 2003 16 Adequate Si- Blind Adequate Described Yes ATES与CT治疗DFU的疗效分析 Study or SubgroupCaravaggi C 2003 21Gen
5、tzkow GD 1996 10Jason R 2002 22Marston WA 2003 24Richard AP 1997 23Sams HH 2002 25Veves AF 2001 12Total (95% CI)Total eventsHeterogeneity: Chi = 5.32, df = 6 (P = 0.50); I = 0%Test for overall effect: Z = 4.28 (P 0.0001)Events2611153940563199Total4337241301099112464Events15162140436123Total361322115
6、126896416Weight9.5%1.5%3.5%23.0%34.7%2.8%25.0%100.0%M-H, Fixed, 95% CI2.14 0.87, 5.275.08 0.59, 43.954.44 1.27, 15.521.92 1.05, 3.511.25 0.73, 2.141.25 0.19, 8.442.14 1.23, 3.741.88 1.41, 2.51TES CT Odds Ratio Odds RatioM-H, Fixed, 95% CI0.01 0.1 1 10 100Favours experimental Favours control不同种类组织工程皮
7、肤疗效亚组分析 Study or Subgroup1.1.1 Dermagraft VS. CTGentzkow GD 1996 10Jason R 2002 22Marston WA 2003 24Richard AP 1997 23Subtotal (95% CI)Total eventsHeterogeneity: Chi = 5.11, df = 3 (P = 0.16); I = 41%Test for overall effect: Z = 3.09 (P = 0.002)1.1.2 Graftskin VS. CTSams HH 2002 25Veves AF 2001 12Su
8、btotal (95% CI)Total eventsHeterogeneity: Chi = 0.27, df = 1 (P = 0.60); I = 0%Test for overall effect: Z = 2.71 (P = 0.007)1.1.3 Hyalograft 3D VS. CTCaravaggi C 2003 21Subtotal (95% CI)Total eventsHeterogeneity: Not applicableTest for overall effect: Z = 1.69 (P = 0.09)Total (95% CI)Total eventsHet
9、erogeneity: Chi = 6.08, df = 6 (P = 0.41); I = 1%Test for overall effect: Z = 4.41 (P 0.0001)Test for subgroup differences: Not applicableEvents11153940105563682626199Total372413010930091121214343464Events16214068436401515123Total13221151262768961043636416Weight4.5%5.3%28.2%27.0%65.0%2.0%23.9%25.9%9
10、.1%9.1%100.0%M-H, Fixed, 95% CI0.22 0.01, 0.430.35 0.08, 0.620.12 0.01, 0.220.05 -0.07, 0.170.12 0.04, 0.190.06 -0.42, 0.530.19 0.05, 0.320.18 0.05, 0.310.19 -0.03, 0.410.19 -0.03, 0.410.14 0.08, 0.20TES CT Risk Difference Risk DifferenceM-H, Fixed, 95% CI-0.5 -0.25 0 0.25 0.5Favours experimental Favours control
