不同非药物干预方式对改善心脏术后患者睡眠质量、疼痛症状的网状Meta分析  

Network Meta-analysis of different non-pharmacological interventions to improve sleep quality and pain symptoms in patients after cardiac surgery

作　　者：沈于琪 程敏 曾智 万丽 蒋庆丽 刘茂 何梅 SHEN Yuqi;CHENG Min;ZENG Zhi;WAN Li;JIANG Qingli;LIU Mao;HE Mei(Department of Intensive Care Unit,Mianyang Central Hospital/Mianyang Hospital School of Medicine Affiliated to University of Electronic Science and Technology of China,Mianyang 621000,China;School of Medicine Affiliated to University of Electronic Science and Technology of China,Chengdu 610000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院/绵阳市中心医院重症医学科,四川绵阳621000 [2]电子科技大学医学院,四川成都610000

出　　处：《现代医学》2024年第12期1869-1878,共10页Modern Medical Journal

基　　金：绵阳市中心医院护理科研课题(MCHHL2024YB07)。

摘　　要：目的:利用网状Meta分析评价不同非药物干预方式对改善心脏术后患者睡眠质量及疼痛症状的效果。方法:计算机检索中国生物医学文献服务系统、中国知网、万方数据知识服务平台、维普中文期刊全文数据库、PubMed、Cochrane Library、Web of Science、Embase,搜集不同非药物治疗护理措施对心脏术后患者睡眠质量及疼痛干预的随机对照试验,检索时限从建库至2024年6月。由2名研究者独立筛选文献、提取资料,评价纳入研究的偏倚风险后,采用Stata 16软件进行网状Meta分析。结果:共纳入16篇随机对照试验,包括1288例患者,涉及11种干预方法。网状Meta分析结果显示:在匹兹堡睡眠质量量表(PSQI)方面,排序概率曲线下面积(SUCRA)值的排序结果为:有氧运动联合八段锦(99.5%)、眼罩(79.0%)、音乐联合视频疗法(63.8%)、渐进式肌肉放松(60.4%)、耳穴压豆(46.8%)、有氧运动(44.7%)、认知行为疗法(31.3%)、芳香疗法(22.5%)、常规护理(2.0%)。在视觉模拟评分量表(VAS)方面,SUCRA值的排序结果为:穴位按压(99.8%)、音乐疗法(78.1%)、渐进式肌肉放松(60.9%)、按摩疗法(56.2%)、眼罩(36.8%)、耳穴压豆(18.0%),常规护理(0.2%)。结论:当前证据表明,在改善心脏术后患者睡眠质量方面,有氧运动联合八段锦可能是最优的非药物干预方式;在缓解心脏术后患者疼痛方面,穴位按压可能是最优的非药物干预方式。Objective:To evaluate the effect of different non-drug interventions on improving sleep quality and pain symptoms in patients after cardiac surgery by using network meta-analysis.Methods:A computer search was conducted on Chinese biomedical Literature Service System,CNKI,Wanfang Data Knowledge Service platform,Weipu Chinese Journal Full text database,PubMed,Cochrane Library,Web of Science,Embase.Randomized controlled trials of different non-pharmacological nursing interventions on sleep quality and pain in patients after cardiac surgery were collected from the database to June 2024.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included studies.Stata 16 software was used to conduct a network Meta-analysis.Results:A total of 16 randomized controlled trials were included,including 1288 patients,involving 11 interventions.The results of network Meta-analysis showed that in terms of Pittsburgh sleep quality index(PSQI),SUCRA values were ranked as follows:aerobic exercise combined with Baduanjin(99.5%),eye mask(79.0%),music combined with video therapy(63.8%),progressive muscle relaxation(60.4%),ear point pressure bean(46.8%),aerobic exercise(44.7%),cognitive behavioral therapy(31.3%),aromatherapy(22.5%),conventional care(2.0%).In terms of visual analogue scale(VAS),the ranking results of SUCRA values are as follows:Acupressure(99.8%),music therapy(78.1%),progressive muscle relaxation(60.9%),massage therapy(56.2%),eye mask(36.8%),ear point pressure bean(18.0%),routine care(0.2%).Conclusion:The current evidence shows that aerobic exercise combined with Baduanjin may be the best non-drug intervention in improving the sleep quality of patients after cardiac surgery.Acupressure may be the best non-drug intervention to relieve pain in patients after cardiac surgery.

关 键 词：心脏术后患者 非药物干预 睡眠质量 疼痛 网状Meta分析 随机对照试验 

分 类 号：R473.5[医药卫生—护理学]