维持性血液透析患者跌倒影响因素的Meta分析  

Meta analysis of factors infl uencing falls in maintenance hemodialysis patients

作　　者：李天华 李来有[1] 赵晓燕[1] 耿同会[1] 薛珊 梁军利[1] LI Tianhua;LI Laiyou;ZHAO Xiaoyan;GENG Tonghui;XUE Shan;LIANG Junli(Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院(河北省石家庄市,050011)

出　　处：《护理实践与研究》2024年第9期1310-1321,共12页Nursing Practice and Research

摘　　要：目的研究采用Meta分析方法,系统评价维持性血液透析患者发生跌倒的影响因素,为医务人员早期识别易发生跌倒的高危患者,降低维持性血液透析患者跌倒的发生率提供参考依据。方法系统检索PubMed、Embase、CINAHL、Web of Science、中国知网、万方医学网、维普和中国生物医学数据库中维持性血液透析患者跌倒影响因素的相关文章,检索时间设定为自建库起至2022年8月。由2名研究者按照标准独立对文献进行筛选、资料提取及质量评价,文献质量评价使用JBI文献质量评价工具,使用Stata 17软件对研究结果进行Meta分析,采用Q检验与I^(2)统计量检验各研究间的异质性,采用Begg’s分析评估各原始文献的发表偏倚。结果本次Meta分析共纳入19篇研究,其中队列研究14篇,横断面研究5篇,共包括5599例患者。Meta分析结果显示,高龄、糖尿病、高血压、低血红蛋白、透析中低血压和衰弱是维持型血液透析患者发生跌倒的独立影响因素(P<0.05),其中年龄大、合并糖尿病、合并高血压、血红蛋白指数偏低、透析中低血压、伴衰弱的患者更易发生跌倒。结论高龄、合并糖尿病、高血压、低血红蛋白的患者,发生透析中低血压以及衰弱的患者更容易发生跌倒。临床应根据这些因素采取针对性的预防措施,降低此类患者发生跌倒的概率。建议在临床实践过程中,医护人员结合临床的实际情境,遵循个性化原则对患者采取相应的预防措施。Objective This research is taking the systematically evaluate the influencing factors of falls in maintenance hemodialysis patients by using the Metaanalysis method,so as to provide a reference for medical staffto identify high-risk easy fall patients at early stage and reduce the incidence of falls in maintenance hemodialysis patients.Methods PubMed,Embase,CINAHL,Web of Science,China National Knowledge Infrastructure,Wanfang Medical Network,Weipu,and China Biomedical Database were systematically searched for relevant articles on factors affecting falls in maintenance hemodialysis patients.The search time was set to be from the establishment of the database to August 2022.Two researchers independently screened,extracted and evaluated the literature according to the standards.The literature quality evaluation used the JBI literature quality evaluation tool,used Stata 17 software to conduct a Meta analysis of the study results,used the Q test and I^(2) the I statistic to test the heterogeneity between the studies,and used Begg's analysis to evaluate the publication bias of the original literature.Results A total of 19 studies were included in this Meta analysis,including 14 cohort studies and 5 cross-sectional studies,including 5,599 patients.The results of the Metaanalysis showed that older age,diabetes,hypertension,hypoglobin,dialysis hypotension,and debilitation were the independent factors(P<0.05)that influenced the occurrence of falls in maintenance hemodialysis patients,of which older age,diabetes mellitus,hypertension,low hemoglobin index,dialysis hypotension,and debilitation were more easily to fall.Conclusion Patients with advanced age,diabetes,hypertension,low hemoglobin inemia,dialysis and hypotension,and weakness more likely to fall,and targeted preventive measures should be taken to reduce the incidence according to those factors of the patients.It is recommended that in the course of clinical practice,medical staffshould take corresponding preventive measures for patients in accordance with the pr

关 键 词：维持性血液透析 跌倒 影响因素 系统评价 META分析 

分 类 号：R473.5[医药卫生—护理学]