使用减压床垫的压疮危险者翻身频次的meta分析  

A meta-analysis of repositioning frequency for preventing pressure ulcers among patients lying in pressurerelief mattress

作　　者：张玉红[1] 蒋琪霞[2] 郭艳侠[1] 徐元玲[1] 

机构地区：[1]南京中医药大学护理学院,南京市210000 [2]南京军区南京总医院伤口护理中心

出　　处：《中华护理杂志》2015年第9期1029-1036,共8页Chinese Journal of Nursing

基　　金：南京军区南京总医院面上课题(2010M012)

摘　　要：目的通过meta分析探讨使用减压床垫的压疮危险者有效预防压疮的翻身频次及其相关证据,为临床选择适当的翻身频次提供依据。方法计算机检索Cochrane Library、Pub Med、MEDLINE、Web of Knowledge、CINAHL、EMbase、Springer、EBSCO、中国生物医学文献数据库、中国知网、万方数据库、维普数据库中使用各种减压床垫的卧床患者不同翻身频次预防压疮的随机对照试验,同时筛检纳入文献的参考文献。由两名研究者对文献质量进行评价和资料提取,对符合质量标准的随机对照试验进行meta分析。结果共纳入11个随机对照试验,包括2711例患者。meta分析结果显示,卧床患者在使用有效减压床垫时翻身频次可延长至每4h 1次[RR=1.18,95%CI(0.88,1.59),P=0.28];2项研究表明,已发生压疮的患者采用减压床垫结合每4h翻身1次可预防新压疮的发生(P=0.32,P=0.24);2项研究结果显示使用减压床垫结合每4h翻身1次没有增加压疮发生率(P>0.05),且可提高患者舒适度(P=0.03);1项研究显示每2h翻身1次比每4h翻身1次带来更多的护理工作量(P<0.001),且器械相关性不良事件增多(P=0.02)。结论卧减压床垫的压疮危险患者可每4h翻身1次,可减少患者不适感,节约医疗卫生资源。Objective To determine the optimal repositioning frequency for patients at high risk of pressure ul- cer lying in pressure-relief mattress in order to provide evidence for clinical practice. Methods Cochrane Library, PubMed,MEDLINE,Web of Knowledge,CINAHL,EMbase,Springer,EBSCO,CBMdisc,CNKI,Wanfang and VIP were searched to collect randomized controlled trails（RCTs）. The quality of RCTs was critically appraised and data were extracted by 2 reviewers independently. Meta-analysis was conducted for eligible RCTs. Results Eleven RCTs and 2711 patients were included. Results of meta-analysis showed that repositioning frequency for patients with pressure- relief mattress could be extended to once every 4 hours[RR=1.18,95%CI（0.88,1.59）,P=0.28]. Two studies indicated that patients with present pressure ulcers could prevent new ones via using pressure-relief mattress with reposition- ing every 4 hours（P=0.32,P=-0.24）. Two studies indicated the use of pressure-relief mattress with repositioning every 4 hours did not increase the incidence of pressure ulcers （P〉0.05）,and improved degree of comfort of patients（P= 0.03）. One research showed repositioning every 2 hours increased daily nursing workload and device-related adverse events（P〈0.001 ,P=0.02）. Conclusion Patients lying in pressure-relief mattress can be turned every 4 hours to reduce patients＇ discomfort and nursing workload.

关 键 词：压力性溃疡 减压床垫 翻身 META分析 

分 类 号：R473[医药卫生—护理学]