心理护理对于气管插管患者护理效果的Meta分析  

Effects of psychological nursing in patients with endotracheal intubation：a Meta analysis

作　　者：严芳琴 范志红[1] 赵辉[2] 

机构地区：[1]鄂州市中心医院急诊科,436000 [2]鄂州市中心医院科教科,436000

出　　处：《中华现代护理杂志》2016年第7期966-971,共6页Chinese Journal of Modern Nursing

摘　　要：目的：评价心理护理应用于气管插管患者护理的效果。方法计算机检索 PubMed、MEDLINE、Cochrane Central Register of Controlled Trials、CNKI全文数据库以及万方数据库资源系统,收集1998年1月—2014年1月公开发表的有关心理护理对于气管插管患者护理效果的随机对照试验（ RCTs）,同时辅以手检纳入文献的参考文献。对文献质量进行严格评价后,符合要求的研究进行资料提取及采用RevMen 5.1软件进行Meta分析。结果共纳入8项RCTs,Meta分析显示：心理护理组与对照组之间依赖发生率（OR=0.65,95%CI：0.23~1.87,P=0.43）、撤机率（OR=1.99,95%CI：0.87~4.52, P=0.10）和撤机后再插管率（OR=0.44,95%CI：0.14~1.41,P=0.17）差异无统计学意义,但在焦虑程度（WMD=-8.68,95%CI：-13.57^-3.79,P=0.0005）、焦虑发生率（OR=0.05,95%CI：0.01~0.38, P=0.003）、郁闷发生率（OR=0.18,95%CI：0.07~0.42,P〈0.001）、恐惧发生率（OR=0.17,95%CI：0.06~0.49,P=0.001）、幻觉发生率（OR=0.34,95%CI：0.15~0.77,P=0.010）、绝望发生率（OR=0.09,95%CI：0.03~0.25,P〈0.001）以及非计划性拔管率（OR=0.15,95%CI：0.05~0.42,P=0.0003）方面差异均有统计学意义。结论对于气管插管患者而言,在一般常规护理的基础上加上心理护理可显著降低患者的焦虑程度、焦虑发生率、郁闷发生率、恐惧发生率、幻觉发生率、绝望发生率以及非计划性拔管率等ICU综合征发生率,建议临床推广使用。Objective To evaluate the effects of psychological nursing in patients with endotracheal intubation. Methods The data were literatures and references of randomized controlled trials （ RCTs） about the effects of psychological nursing on patients with endotracheal intubation, which published from January 1998 to January 2014. The data were collected from the databases of PubMed,MEDLINE,Cochrane Central Register of Controlled Trials, CNKI and Wanfang Database. The qualified data were extracted from valid RCT and Meta analyzed using RevMan 5. 1 software. Results There were eight RCTs involved in the research and Meta-analysis showed that there were no statistical difference between psychological nursing group and control group in dependence rate （OR=0. 65, 95%CI：0. 23-1. 87, P=0. 43）, weaning ventilator rate （OR=1. 99, 95%CI：0. 87-4. 52, P=0. 10）, and reintubation rate （OR=0. 44, 95%CI：0. 14-1. 41, P=0. 17）. However, the statistical significances shown in anxiety degree （WMD= -8. 68, 95%CI： -13. 57- -3. 79,P=0. 0005）,anxiety （OR=0. 05, 95%CI：0. 01-0. 38, P=0. 003）, depression （OR=0. 18, 95%CI：0. 07~0. 42, P〈0. 001）, fear （OR=0. 17, 95%CI：0. 06-0. 49, P=0. 001）, hallucination （OR=0. 34, 95%CI：0. 15-0. 77, P=0. 010）, desperation （OR=0. 09, 95%CI：0. 03 -0. 25, P〈0. 001） and unplanned extubation （OR=0. 15, 95%CI：0. 05-0. 42, P=0. 0003）. Conclusions Based on the routine nursing, psychological nursing can significantly decrease the ICU syndromes in patients with endotracheal intubation, such as anxiety degree and incidence rate, depression, fear, hallucination, desperation, and unplanned extubation.

关 键 词：心理护理 气管插管 护理 META分析 

分 类 号：R472[医药卫生—护理学]