综合护理干预措施对ICU住院病人谵妄影响的网状Meta分析  

Effect of comprehensive nursing intervention on delirium in ICU inpatients:a mesh Meta-analysis

作　　者：杨丽 李敏 李亚男[2] 田金徽[2] YANG Li;LI Min;LI Yanan;TIAN Jinhui(The First People′s Hospital of Lanzhou City,Gansu 730050 China)

机构地区：[1]兰州市第一人民医院,730050 [2]兰州大学循证医学中心,730000

出　　处：《循证护理》2019年第11期968-975,共8页Chinese Evidence-Based Nursing

摘　　要：[目的]以网状Meta分析方法评价综合护理干预措施对重症监护室(ICU)住院病人发生谵妄的影响。[方法]计算机检索PubMed、EMbase、the Cochrane Library、中国生物医学文献数据库、中国知网和万方数据库,检索综合护理措施与常规护理措施干预的ICU发生病人谵妄的随机对照试验,检索时限均为从建库至2017年4月21日。由2位评价员独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用StataSE 12.0软件进行数据分析。[结果]共纳入24项RCT。网状Meta分析结果显示,在谵妄发生率方面,增加家属探视时间+认知功能锻炼+音乐疗法优于其他护理干预措施;在改善焦虑方面,认知功能锻炼优于其他护理干预措施;在ICU接受监护的平均时间方面,增加家属探视时间+音乐疗法优于其他护理干预措施;在健康程度评分方面,循证护理、运动结合眼罩优于其他护理干预措施;在机械通气时间方面,谵妄的管理优于其他护理干预措施;在谵妄值方面,认知功能锻炼优于其他护理干预措施;差异均有统计学意义(P<0.05)。[结论]现有证据表明:对ICU住院病人发生谵妄的影响,各类护理措施各有优劣,建议结合临床实际情况合理选择。Objective:To evaluate the effect of comprehensive nursing intervention on delirium in ICU inpatients by means of mesh Meta analysis.Methods:Randomized controlled trial(RCTs)on comprehensive nursing interventions and nursing care among hospitalized patients with ICU in the following databases,PubMed,EMbase,the Cochrane Library,CBM CNKI and WanFang Data database were retrieved from inception to 21 April,2017.The dataes were analyzed by StataSE 12.0 software after two researchers independently screening documents,extracting data and evaluating the bias risks.Results:A total of 24 RCTs were included,Mesh Meta-analysis results showed that:in the incidence of delirium,increased visitation time,cognitive function exercise and music therapy wes better than other nursing interventions.In regard to the self rating Anxiety Scale(SAS),the exercise of cognitive function was better than other nursing care.As regards the accept the average time in ICU(d),increased visitation time and music therapy were better than other nursing intervention;health score,evidence-based nursing exercise,combined with patch,better than other nursing intervention measures;On the time of mechanical ventilation,the management of delirium was better than other nursing interventions;values in delirium the cognitive function,exercise was better than other nursing interventions.There were significant statistiacal differences(all P<0.05).Conclusion:Current evidence shows that:for the patients with delirium in ICU,the various nursing measures have advantages or disadvantages,it is recommended to choose a reasonable nursing plan on the basis of clinical practice.

关 键 词：网状Meta分析 护理干预措施 重症监护室 谵妄 

分 类 号：R47[医药卫生—护理学]