心理干预对腹腔镜胆囊切除术患者影响的Meta分析  

Effects of psychological intervention for patients who adopted laparoscopic cholecystectomy:a Meta-analysis

作　　者：马志远[1] 严祥[1] 王文进[2] 

机构地区：[1]兰州大学第一医院老年病二科,甘肃兰州730000 [2]兰州大学第一医院急诊科,甘肃兰州730000

出　　处：《国外医学（医学地理分册）》2016年第2期112-118,共7页Foreign Medical Sciences：Section of Medgeography

摘　　要：目的运用meta分析的方法探究心理干预对改善腹腔镜胆囊切除术患者围手术期指标的有效性。方法全面收集国内外2016年3月前公开发表的随机对照试验(RCT),评价纳入研究的质量,并提取资料后采用RevMan 5.0软件行合并分析。结果共纳入35项RCT。Meta分析结果显示:与对照组相比,心理干预组的患者的心率、收缩压和术前各类评分明显改善。同时其显著缩短了手术时间、住院时间,降低了术后6h[MD=-1.20,95%CI(-1.29,-1.11)]和12hVAS评分[MD=-1.14,95%CI(-1.67,-0.61)]、术后排气时间[MD=-9.24,95%CI(-11.68,-6.80)]和下床活动时间[MD=-15.43,95%CI(-21.03,-9.83)]。此外,其还减少了术后并发症[OR=0.28,95%CI(0.13,0.58)],提高了护理满意度[OR=3.27,95%CI(2.18,4.90)]。而在减缓术前1d心率,降低术后24h VAS疼痛评分方面无差异。结论心理干预可显著提高患者心理应激能力,缓解术前焦虑抑郁情绪及术后疼痛,促进患者康复,并提高患者满意度。但鉴于纳入研究质量不高,仍需大样本的随机对照临床试验进一步证实。Objective To evaluate the efficacy of psychological intervention in improving perioperative index for patients who underwent laparoscopic cholecystectomy.Methods Relevant randomized controlled trials（RCTs）published up to March2016 were searched.Study quality was assessed and data were analyzed by RevMan 5.0software.Results A total of 35 RCTs were included.Meta-analysis results showed that compared with control,psychological intervention significantly decreased heart rates,systolic pressure,diastolic pressure and pre-operative scale scores.Operation time [MD=-1.20,95%CI（-1.29,-1.11）],hospital stay [MD=-1.14,95%CI（-1.67,-0.61）],VAS score 6 h and12 h,as well as first exhaust time[MD=-9.24,95%CI（-11.68,-6.80）]and ambulation time[MD=-15.43,95%CI（-21.03,-9.83）]were reduced.Besides,it decreased the incidence of complications[OR=0.28,95%CI（0.13,0.58）]and promoted the degree of satisfaction [OR =3.27,95%CI（2.18,4.90）].However,no effect in decreasing heart rates and VAS score 24 h was observed.Conclusion Psychological intervention plays a role in improving pre-operative psychological stress and anxiety,as well as post-operative pain,recovery and satisfaction.Due to low quality of included studies,more high quality studies are still wanted.

关 键 词：心理干预 腹腔镜胆囊切除术 META分析 

分 类 号：R575[医药卫生—消化系统]