延续性护理对脑卒中偏瘫患者运动功能及自理能力影响的Meta分析  

Meta-analysis of the effect of continuous nursing on the motor function and self-care ability of stroke patients with hemiplegia

作　　者：仇志琴 李壮苗[1] 黄惠榕 余梦婷 李施恩 池艳红 QIU Zhiqin;LI Zhuangmiao;HUANG Huirong;YU Mengting;LI Shien;CHI Yanhong(Nursing College of Fujian University of Chinese Medicine,Fuzhou,350122,China)

机构地区：[1]福建中医药大学护理学院,福建省福州市350122 [2]福建中医药大学附属人民医院

出　　处：《护理实践与研究》2022年第2期220-228,共9页Nursing Practice and Research

摘　　要：目的系统评价延续性护理干预对脑卒中偏瘫患者运动功能及日常生活自理能力(ADL)的影响。方法计算机检索Cochrane Library、PubMed、CBM、维普中文科技期刊数据库(VIP)、中国知网数据库(CNKI)、万方数据知识服务平台(WanFang Data)、EMbase数据库,检索年限为建库至2021年6月,纳入脑卒中偏瘫患者的延续性护理干预随机对照试验,采用RevMan 5.4软件进行Meta分析、采用StataSE 15.0软件对异质性进行探讨。结果①共纳入16项研究,1566例患者;②Meta分析结果显示,延续性护理干预可提高患者的肢体运动功能(FMA评分)[MD=15.51,95%CI(12.84,18.17),P<0.00001]、ADL评分[SMD=1.80,95%CI(1.29,2.31),P<0.00001]、生活质量总评分[MD=15.83,95%CI(14.26,17.40),P<0.00001];③Meta回归分析结果显示,影响患者ADL评分异质性来源的是干预时间及患者平均年龄;④亚组分析结果显示,对平均年龄55~65岁的患者干预≤3个月及干预>3个月,干预组ADL评分均优于对照组,差异具有统计学意义,其效应量分别为[SMD=1.30,95%CI(1.13,1.47),P<0.00001]、[SMD=2.77,95%CI(2.41,3.13),P<0.00001]。结论现有证据证明,延续性护理干预可改善脑卒中患者运动功能、日常生活自理能力、生活质量总状态,由于纳入文献质量不高,结论尚需规范的大样本、多中心RCT以进一步验证。Objective To systematically evaluate the effects of continuous nursing intervention on motor function and activities of daily living(ADL)in stroke patients with hemiplegia was set as the study objects.Methods We searched the Cochrane Library,PubMed,CBM,VIP,CNKI,Wanfang Data,and EMbase databases by computer,and the search period was from the establishment of the database to June 2021,included randomized controlled trials of continuous nursing intervention for stroke patients with hemiplegia,and used RevMan 5.4 software for Meta analysis and StataSE 15.0 software to explore heterogeneity.Results A total of 16 studies with 1,566 patients were included.Meta analysis showed that the continuous nursing intervention can improve the patient's motor function(FMA score)[MD=15.51,95%CI(12.84,18.17),P<0.00001],ADL score[SMD=1.80,95%CI(1.29,2.31),P<0.00001],and total quality of life score[MD=15.83,95%CI(14.26,17.40),P<0.00001].Meta regression analysis showed that the source of the heterogeneity of patients'ADL scores was the intervention time and the average age of patients.The results of subgroup analysis showed that for patients with an average age of 55 to 65 years of intervention for≤3 months and intervention for>3 months,the ADL scores of the intervention group were better than those of the control group,and the diff erence was statistically signifi cant.The eff ect sizes were[SMD=1.30,95%CI(1.13,1.47),P<0.00001],[SMD=2.77,95%CI(2.41,3.13),P<0.00001].Conclusion The existing evidence proved that continuous nursing intervention can improve the motor function,self-care ability of daily life,and overall quality of life in stroke patients.Due to the low quality of the included literature,the conclusion needs to be further verifi ed by a standardized large sample and multi-center RCT.

关 键 词：延续性护理 脑卒中 运动功能 日常生活自理能力 META分析 

分 类 号：R473.5[医药卫生—护理学]