采用减压床垫病人不同翻身间隔时间预防压疮的网状Meta分析  

Network Meta-analysis of repositioning frequency for pressure ulcers among patients lying in pressure-relief mattress

作　　者：宋俐[1] 王欣怡 张珺[1] 侯宇颖[2] 刘美玲[3] 杨丽梅[3] 

机构地区：[1]甘肃中医药大学 [2]兰州大学第一临床学院 [3]甘肃省人民医院

出　　处：《循证护理》2018年第7期577-583,共7页Chinese Evidence-Based Nursing

摘　　要：[目的]基于贝叶斯网状Meta分析方法探讨使用减压床垫的压疮危险者的最佳翻身间隔时间。[方法]计算机检索了Cochrane Library、PubMed、Web of Science、EBSCO、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方期刊论文数据库等中外文数据资源,纳入探讨不同翻身间隔时间对采用减压床垫病人压疮预防效果的随机对照试验(RCT)。检索时限从建库至2016年11月。采用Cochrane系统评价手册5.1.0版提供的偏倚风险评估工具对纳入RCT进行质量评价。数据提取和质量评价均由2名研究者独立进行。采用ADDIS软件及R软件进行数据处理。[结果]最终纳入12项RCT,共2 799例病人。网状Meta分析结果显示,与6h翻身1次相比,2h、3h和4h翻身1次在预防压疮发生方面均较优,差异有统计学意义(P<0.05)。根据ADDIS排序结果,3h翻身1次成为最好干预措施的可能性最高。[结论]使用减压床垫的压疮危险病人翻身间隔时间延长至3h不增加其发生压疮的危险。未来研究应关注不同翻身时间对病人其他相关并发症的影响。Objective：To explore the best interval of repositioning for patients at high risk of pressure ulcer lying on pressure-relief mattresses by using Bayesian network Meta-analysis.Methods：Cochrane Library,PubMed,Web of Science,EBSCO,Chinese Biomedical Literature Database（CBM）,Chinese Knowledge Infrastructure（CNKI）and Wanfang Database were searched from their inception to November,2016 for collecting randomized controlled trails（RCT）which explore the effects of different intervals of repositioning for prevention of pressure ulcer for patients lying on pressure-relief mattresses.Methodological quality of included RCTs was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0.All datas were screened,extracted and reviewed by 2 researchers independently and analyzed using ADDIS and R softwares.Results：Finally,12 RCTs and 2 799 patients were included.Results of network Meta-analysis showed that compared with 6 hours turning strategy,2 hours、3 hours and 4 hours were better in prevention pressure ulcer and had significant differences（P〈0.05）.According to ADDIS ranking results showed that 3 hours was more likely to be the best intervention measures to prevent pressure ulcers.Conclusions：Repositioning frequency of patients using decompression mattresses could be extended to once every 3 hours,which don′t increase the incidence rate of pressure ulcers.Researchers should focus on the influence of different intervals of repositioning for patients with other related complications.

关 键 词：压疮 减压床垫 翻身间隔时间 网状Meta分析 

分 类 号：R47[医药卫生—护理学]