国外护士主导的自我管理教育对糖尿病患者血红蛋白影响的Meta分析  

The effect of foreign nurse-led diabetes self-management education on glycosylated hemoglobin: a meta-analysis

作　　者：宋歌 周燕 

机构地区：[1]上海市杨浦区安图医院护理部,上海200093

出　　处：《当代护士（中旬刊）》2014年第4期1-7,共7页Modern Nurse

摘　　要：目的采用循证医学Meta分析方法定量评价护士主导的自我管理教育对糖尿病患者血红蛋白(HbA1c)的影响。方法检索PubMed、EMBASE、Web of Science等英文数据库,全面收集有关糖尿病自我管理教育的随机对照试验研究,数据运用STATA 12.0软件进行汇总分析,采用加权均数差(weighted mean difference,WMD)及其95%可信区间(95%confidence interval,95%CI)描述关联。结果严格根据纳入和排除标准,最终共纳入33项研究,共包括8225例患者,其中干预组包括4305例糖尿病患者,对照组包括3920例糖尿病患者。Meta分析结果显示:随访前干预组和对照组糖尿病患者的基线HbA1c差值无统计学差异,而随访结束后干预组患者HbA1c优于对照组。根据患者的不同年龄段的亚组Meta分析结果表明成人干预组患者的HbA1c优于对照组,然而在青少年与老年人两个年龄段患者的HbA1c2组间差异无统计学意义。根据糖尿病类型进行亚组分析时,结果显示干预组2型糖尿病、1型和2型糖尿病(混合型糖尿病)患者的HbA1c优于对照组,然而1型糖尿病患者的HbA1c2组间差异无统计学意义。结论现有证据表明,护士主导的自我管理教育对成年糖尿病患者、2型糖尿病患者以及混合型糖尿病患者的HbA1c干预效果更佳。Objective The purpose of this meta-analysis was to determine the effect of nurse-led diabetes self-management education （DSME） on blood glucose control. Methods The electronic databases PubMed、EMBASE and Web of Science were searched for relevant ran-domized controlled studies published. Effect size was calculated for change in HbA1C using both fixed-and random-effects models. Results A total of 33 randomized controlled trials with a combined cohort size of 8225 patients were identified with 3920 patients in the control group. The effect of the intervention group was better than the control group in type 2 diabetes and mixed diabetes. Conclusion Nurse-led DSME is associ-ated with improved glycemic control,demonstrating that programs are most effective among seniors、type 2 diabetes and mixed diabetes.

关 键 词：自我管理教育 糖尿病 血红蛋白 META分析 

分 类 号：R473.5[医药卫生—护理学]