临床路径应用于高血压患者的Meta分析  

The Meta analysis of the application of clinical pathway in patients with hypertension

作　　者：李腾[1] 谢晖[2] 

机构地区：[1]西安医学院护理学院,陕西西安710021 [2]蚌埠医学院护理学系,安徽蚌埠233030

出　　处：《蚌埠医学院学报》2015年第9期1257-1262,共6页Journal of Bengbu Medical College

基　　金：安徽省高等学校教学研究重点课题(2012jyxm303)

摘　　要：目的:采用Meta分析方法探讨临床路径对高血压患者的影响。方法:计算机检索中国期刊全文数据库、中文科技期刊全文数据库、万方数据库、中国生物学文献数据库等,收集国内有关临床路径法和传统治疗法在高血压患者中应用效果的对照研究。通过严格质量评价,采用Rev Man 5.1软件进行Meta分析。结果:最终纳入15篇文献,共2 083例研究对象,临床路径组1 035例,传统治疗组1 048例。Meta分析结果显示:临床路径组和传统治疗组在住院天数[WMD=-3.15,95%CI(-4.64^-1.65),P<0.01]、住院费用[WMD=-615.70,95%CI(-648.03^-583.38),P<0.01]、患者满意度[RR=1.26,95%CI(1.21~1.30),P<0.01]、健康知识掌握情况[RR=1.29,95%CI(1.22~1.37),P<0.01]、收缩压[WMD=-13.97,95%CI(-16.47^-11.47),P<0.01]、舒张压[WMD=-4.70,95%CI(-5.82^-3.59),P<0.01]及遵医行为[RR=1.24,95%CI(1.19~1.28),P<0.01]方面差异均有统计学意义。结论:临床路径法应用于高血压患者的效果优于传统治疗法。但是纳入研究文献的质量差异较大,需要更加设计严谨、样本量大的随机对照试验来证实此结论。Objective：To explore the effects of clinical pathway on patients with hypertension using Meta analysis. Methods：The application effects of the clinical pathway method and traditional treatment method on patients with hypertension were investigated by screening CNKI, VIP, Wanfang database and CBMdisc. Through the strict quality evaluation, all data were analyzed by using Rev Man 5.1 software. Results：Two thousand and eighty- three objects from 15 documents were selected, which were divided into the clinical path way group （ 1 035 cases） and traditional treatment group （ 1 048 cases）. The Meta-analysis results showed that the differences of the length of hospital stay [ IVMD = - 3.15,95 % CI （ - 4.64 - - 1.65 ）, P 〈 0.01 ], hospitalization expenses [ WMD = - 615.70,95 % CI （ - 648.03 - - 583.38 ）, P 〈 0.01 ], satisfaction degree of patients [ RR = 1.26,95% CI（ 1.21 - 1.30 ）, P 〈 0.01 ], knowledge of health[ RR = 1.29,95%, CI（ 1.22 - 1.37 ）, P 〈 0.01 ], systolic blood pressure [ WMD = - 13.97,95 % CI（ - 16.47 -- 11.47 ）, P 〈 0.01 ], diastolic blood pressure [ WMD = -4.70,95 % CI（ -5.82 - - 3.59）, P 〈 0.01 ] and compliance behavior[ RR = 1.24,95 % CI （ 1. 19 - 1.28 ）, P 〈 0.01 ] between two groups were statistically significant. Conclusions ： The effect of clinical path way in the application of patients with hypertension is better than that of traditional treatment. Because of the large differences of the quality of the documents and large samples, the design need more rigorous, and randomized controlled trial can be used to confirm this conclusion.

关 键 词：高血压 临床路径 META分析 

分 类 号：R544.1[医药卫生—心血管疾病]