身体约束与ICU患者谵妄发生风险关系的Meta分析  

Meta-analysis of the relationship between physical restraint and the risk of delirium in ICU patients

作　　者：肖青青 宋小珍[1,2] 喻红 黄秀梅[1,2] 肖艳 XIAO Qingqing;SONG Xiaozhen;YU Hong;HUANG Xiumei;XIAO Yan(Mental Health Center,West China Hospital,Sichuan University,Chengdu,610000,China;West China School of Nursing,Sichuan University,Chengdu,610000,China)

机构地区：[1]四川大学华西医院心理卫生中心,成都市610000 [2]四川大学华西护理学院,成都市610000

出　　处：《中国护理管理》2021年第6期892-897,共6页Chinese Nursing Management

基　　金：四川省卫生健康委员会科研课题普及应用项目(20PJ014);华西护理学科发展专项基金项目(HXHL19026)。

摘　　要：目的:系统评价身体约束与ICU患者谵妄发生风险的关系。方法:检索PubMed、EMbase、CENTRAL、Web of Science、CBM、CNKI、VIP、WanFang Data数据库中有关身体约束与ICU患者谵妄发生关系的队列研究,检索时间均为建库至2020年12月31日。由2名研究者独立按纳入排除标准筛选文献和提取数据,对纳入研究采用纽卡斯尔-渥太华量表进行质量评价,使用RevMan 5.3软件对数据进行Meta分析。结果:共纳入13项研究,5948例患者。结果显示,身体约束会增加ICU患者谵妄的发病风险[OR=6.47(3.40~12.31),P<0.001]。亚组Meta分析结果显示,综合ICU或专科ICU的身体约束患者谵妄发病风险均增加[OR=7.30(3.13~17.05),P<0.001;OR=5.67(1.84~17.51),P=0.003];亚洲或非亚洲地区的ICU患者身体约束会增加谵妄的发病风险[OR=4.86(2.56~9.23),P<0.001;OR=14.96(2.34~95.62),P=0.004]。结论:现有证据表明,身体约束可能会增加ICU患者谵妄的发病风险,但上述结果仍需更多高质量研究进一步验证。Objective:To systematically evaluate the relationship between physical restraint and the risk of delirium in ICU patients.Methods:Search PubMed,EMbase,CENTRAL,Web of Science,CBM,CNKI,VIP and WanFang Data database for cohort studies on the relationship between physical restraint and the risk of delirium in ICU patients.The retrieval time was from the establishment of the database to December 31,2020.Two researchers independently screened the literature and extracted data according to inclusion and exclusion criteria.The Newcastle-Ottawa Quality Scale(NOS)was used to evaluate the quality of the included studies,and the RevMan 5.3 software was used to conduct Meta-analysis of the data.Results:A total of 13 studies involving 5948 patients were included.Meta-analysis results showed that physical restraint could increase the risk of delirium in ICU patients[OR=6.47(3.40-12.31),P<0.001].The results of subgroup Meta-analysis showed that the risk of delirium in physical restraint patients in comprehensive ICU or specialized ICU increased[OR=7.30(3.13-17.05),P<0.001;OR=5.67(1.84-17.51),P=0.003];physical restraint of ICU patients in Asian or non-Asian regions increased the risk of delirium[OR=4.86(2.56-9.23),P<0.001;OR=14.96(2.34-95.62),P=0.004].Conclusion:Current evidence suggested that physical restraint may increase the risk of delirium in ICU patients and more high-quality studies are needed to verify the above conclusions.

关 键 词：身体约束 谵妄 ICU患者 META分析 

分 类 号：R47[医药卫生—护理学]