ICU患者使用身体约束影响因素的系统评价和Meta分析  

A systematic review and Meta-analysis of factors influencing the use of physical restraint in ICU patients

作　　者：王俊辉 沈佩烨 沈欣怡 鲁佳 陈肖敏[3] WANG Junhui;SHEN Peiye;SHEN Xinyi;LU Jia;CHEN Xiaomin(School of Nursing,Zhejiang University of Traditional Chinese Medicine,Hangzhou 310053,Zhejiang,China;School of Nursing,School of Medicine of Huzhou Normal University,Huzhou 313000,Zhejiang,China;Department of Nursing,Zhejiang Provincial People’s Hospital,Hangzhou 310014,Zhejiang,China)

机构地区：[1]浙江中医药大学护理学院,浙江杭州310053 [2]湖州师范学院医学院护理学院,浙江湖州313000 [3]浙江省人民医院护理部,浙江杭州310014

出　　处：《中国现代医生》2023年第27期72-78,83,共8页China Modern Doctor

摘　　要：目的通过系统评价和Meta分析明确ICU患者使用身体约束的影响因素。方法计算机检索PubMed、EmBase、The Cochrane Library、Web of Science、CINAHL、中国知网、万方、维普、中国生物医学文献数据库,检索时限均为建库至2022年5月。由2名研究人员独立筛选文献、提取资料及评价偏倚风险后,对ICU患者身体约束的影响因素进行描述性分析,并采用RevMan 5.3软件进行Meta分析。结果共纳入17篇文献,样本量合计6090例。描述性分析结果显示:共发现31项与ICU患者使用身体约束相关的影响因素;Meta分析结果显示:轻度意识障碍(OR=3.31,95%CI:1.84~5.97)、中度意识障碍(OR=13.10,95%CI:6.55~26.18)、谵妄(OR=6.50,95%CI:4.19~10.08)、使用镇静药物(OR=2.39,95%CI:1.40~4.09)、机械通气(OR=5.48,95%CI:2.62~11.44)是ICU患者身体约束的危险因素。结论轻度意识障碍、中度意识障碍、谵妄、使用镇静药物、机械通气是ICU患者使用身体约束的独立危险因素。受纳入研究数量和质量的限制,其他影响因素仍需高质量的研究予以验证。Objective To clarify the influencing factors of physical restraint in ICU patients through systematic review and Meta-analysis.Methods We searched PubMed,EmBase,the Cochrane Library,Web of Science,CINAHL,CNKI,WanFang,VIP database and CBM from the establishment of the database to May 2022.After independently screening literature,extracting data and evaluating the risk of bias of the included literature,we conducted a descriptive analysis of the influencing factors of physical restraint in ICU patients and used RevMan 5.3 software for Meta-analysis.Results A total of 17 studies were included,with a total sample size of 6090.The results of descriptive analysis showed that a total of 31 influencing factors related to the use of physical restraint in ICU patients were found.The results of Meta-analysis showed that mild disturbance of consciousness(OR=3.31,95%CI:1.84~5.97),moderate disturbance of consciousness(OR=13.10,95%CI:6.55~26.18),delirium(OR=6.50,95%CI:4.19~10.08),sedative drugs using(OR=2.39,95%CI:1.40~4.09),mechanical ventilation(OR=5.48,95%CI:2.62~11.44)were risk factors for physical restraint in ICU patients.Conclusion Mild disturbance of consciousness,moderate disturbance of consciousness,delirium,sedative drugs and mechanical ventilation are independent risk factors for physical restraint in ICU patients.Limited by the quantity and quality of the included studies,other influencing factors still need to be verified by further studies.

关 键 词：身体约束 重症监护室 影响因素 META分析 

分 类 号：R47[医药卫生—护理学]