国内护理干预对乳腺癌患者依从性影响文献的meta分析  

Influence of nursing intervention on the compliance of patients with breast cancer:a meta analysis on domestic RCT literature

作　　者：韩燕[1] 王清馨[2] 罗丹[1] 王培培[1] 

机构地区：[1]山西医科大学护理学院,太原030001 [2]山西省肿瘤医院

出　　处：《中国临床护理》2017年第1期1-5,共5页Chinese Clinical Nursing

基　　金：山西省回国留学人员科研资助项目(编号:2012093)

摘　　要：目的评价护理干预对乳腺癌患者化疗依从性、患肢功能锻炼依从性、减轻化疗不良反应及并发症发生率的影响。方法通过在中国知网全文数据库、中国生物医学文献数据库、万方数据库、山西医科大学移动图书馆检索护理干预对乳腺癌患者依从性影响的随机对照实验的文献,由2名评价员独立检索、筛查文献、提取数据、评价纳入文献的方法学质量并交叉核对后,筛选出符合评价标准的文献,用RevMan 5.0软件进行meta分析。结果共纳入8篇文献,累计病例732例。Meta分析结果显示,护理干预有助于提高乳腺癌患者化疗依从性[OR=5.79,95%CI(2.59,12.93),P<0.001];肢体功能锻炼依从性[OR=5.57,95%CI(2.59,11.99),P<0.001];减轻化疗引起的恶心、呕吐[OR=0.28,95%CI(0.12,0.68),P<0.005]、口腔溃疡[OR=0.18,95%CI(0.05,0.69),P=0.01]、降低静脉炎的发生率[OR=0.18,95%CI(0.04,0.85),P=0.03],而肢体肿胀发生率方面差异无统计学意义[OR=0.42,95%CI(0.12,1.41),P=0.16]。结论护理干预能改善乳腺癌患者化疗、患肢功能锻炼依从性,减轻化疗不良反应及静脉炎的发生,从而提高患者的生存质量。Objective Toevaluate the effect of nursing intervention on the chemotherapy compliance and limb function exercises of the patients with breast cancer, as well as the effect of reducing chemotherapy-related adverse reactions and complications. Methods Randomized controlled trials concerning the nursing effect on compliance of breast cancer pat ients were searched and screened in databases such as Chinese national knowledge infrastructure,Chinese biomedical literature database,Wanfang database and Shanxi medical university mobile library by two reviewers independently. After data extraction evaluation of the methodological and cross check, the selected literature was given meta-analysis using Revman 5.0 software. Results A total of 8 randomized controlled studies and 732 cases were included. Meta analysis results showed that the nursing intervention had significantly improved chemotherapy compliance [ OR = 5. 79, 95% CI （2. 59,12. 93）, P 〈 0. 0 0 1 ] and limb function exercises compliance [OR = 5. 5 7, 95 % CI （2. 59,1. 99） , P 〈0. 001] ,significantly decreased the incidence of chemothe rapy -induced adverse reactions, including nausea/vomiting [OR = 0. 28,95 %CI（0. 12, 0. 6 8 ）,P 〈0. 0 0 5 ] and oral ulcer [OR = 0. 18, 95%CI（0. 05, 0. 69）, P = 0. 01], as well as the phlebitis [OR = 0. 18, 95%CI （0. 04,0. 85）,F =0. 03] . However ,no significant differences were observed in the swelling of the limbs [OR = 0. 42,95 % CI （0. 12 , 1. 41）,F = 0. 16 ] . Conclusion Nursing intervention can improve chemotherapy and limb function exercise inpatients with breast cancer ,reduce their adverse reactions of chemotherapy （including nausea , vomiting and oralulcer） and thrombophlebitis ,so as to improve their quality of life.

关 键 词：护理干预 乳腺癌 依从性 META分析 

分 类 号：R473.73[医药卫生—护理学]