ICU日记对重症患者及家属影响的Meta分析  

Efficacy of intensive care unit diaries on patients and relatives:a meta-analysis

作　　者：王维佳 李定艮 陈廖林 刘欣 杨永红[1,2] WANG Weijia;LI Dinggen;CHEN Liaolin;LIU Xin;YANG Yonghong(Department of Rehabilitation Medicine,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;Key Laboratory of Rehabilitation Medicine of Sichuan Province,Chengdu 610041,P.R.China;Department of Rehabilitation Medicine,Sichuan Province Orthopedic Hospital,Chengdu 610041,P.R.China;Department of Rehabilitation Medicine,Affiliated Hospital of North Sichuan Medical College,Nancong 637000,P.R.China)

机构地区：[1]四川大学华西医院康复医学科,成都610041 [2]康复医学四川省重点实验室,成都610041 [3]四川省骨科医院康复科,成都610041 [4]川北医学院附属医院康复医学科,四川南充637000

出　　处：《中国循证医学杂志》2024年第5期557-564,共8页Chinese Journal of Evidence-based Medicine

基　　金：国家重点研发计划项目(编号:2022YFC3601105)。

摘　　要：目的 系统评价ICU日记对重症患者及家属心理认知、生活质量的影响。方法 计算机检索PubMed、Embase、Web of Science、Cochrane Library、PsycINFO、CNKI、WanFang Data和VIP数据库,搜集与研究目的相关的研究,检索时限均为建库至2023年8月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果 共纳入17项研究,包括2 093例患者,786例家属。Meta分析结果显示,与对照组相比,ICU日记能够有效降低患者创伤后应激障碍[RR=0.64,95%CI(0.50,0.83),P<0.01]和抑郁的发生率[RR=0.65,95%CI(0.48,0.89),P<0.01],提高患者生活质量[MD=7.78,95%CI(4.37,11.18),P<0.01],但对患者焦虑、记忆及家属心理影响尚无显著影响。结论 当前证据显示,ICU日记可以降低患者出ICU后创伤后应激障碍、抑郁的发生率,提高患者生活质量,但对患者家属的影响还需要更进一步的研究来确定。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。Objective To systematically review the efficacy of ICU diaries on psychological outcomes,cognition and health-related quality of life in both patients and their relatives.Methods The PubMed,Embase,Web of Science,Cochrane Library,PsycINFO,CNKI,WanFang Data and VIP database were electronically searched to collect trails related to the objective from inception to August 2023.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Meta-analysis was then performed using RevMan 5.3 software.Results A total of 17 studies involving 2093 patients and 786 relatives were included.The results of meta-analysis showed that compared with the control group,ICU diaries could improve patients’post-traumatic stress disorder(PTSD)(RR=0.64,95%CI 0.50 to 0.83,P<0.01),depression(RR=0.65,95%CI 0.48 to 0.89,P<0.01)and quality of life(MD=7.78,95%CI 4.37 to 11.18,P<0.01)significantly.However,there were no significant differences in patients’anxiety,memory and relatives’psychological outcomes.Conclusion Current evidence shows that the use of ICU diaries can reduce the incidence rate of patients’PTSD,depression and improve their quality of life,but other effects are unclear.Due to the limited quantity and quality of the included studies,more high-quality studies are needed to verify the above conclusion.

关 键 词：重症监护病房 ICU日记 创伤后应激障碍 生活质量 META分析 系统评价 

分 类 号：R459.7[医药卫生—急诊医学]