国内缩减约束方案对ICU患者身体约束干预效果的Meta分析  

Meta-analysis of the Effect of Domestic Restraint Reduction Program on Physical Restraint Intervention in ICU Patients

作　　者：胡雅静 颜立春 王之仪 俞纤 易小聪 谭素文 张银华[1,2] HU Yajing;YAN Lichun;WANG Zhiyi;YU Xian;YI Xiaocong;TAN Suwen;ZHANG Yinhua(College of Nursing,Hunan University of Traditional Chinese Medicine,Changsha 410208,Hunan,China;Nursing Department of Changde Hospital Affiliated to Hunan University of Traditional ChineseMedicine,Changde 415000,Hunan,China)

机构地区：[1]湖南中医药大学护理学院,湖南长沙410208 [2]湖南中医药大学附属常德医院护理部,湖南常德415000

出　　处：《医学信息》2025年第3期26-32,共7页Journal of Medical Information

基　　金：2023年度常德市技术研发和技术创新引导项目(编号:2023YD39);湖南省研究生科研创新项目(编号:CX20230831)。

摘　　要：目的系统评价缩减约束方案在重症监护室患者中使用身体约束干预的效果。方法通过计算机检索PubMed、Web of Science、Eebase、The Cochrane Library、CNKI、VIP、Wanfang Data、CBM 8个数据库中有关ICU患者使用缩减约束方案的随机对照试验,检索时限为建库至2023年4月30日。由2名研究者根据Cochrane系统评价方法对纳入文献独立进行筛选、提取资料,并评价纳入文献的偏倚风险,对符合纳入标准的文献采用RevMan 5.3软件进行Meta分析。结果共纳入12篇研究,3250例患者。Meta分析结果显示,与常规身体约束护理相比,缩减身体约束方案能降低非计划拔管率[RR=0.30,95%CI(0.20,0.46),P<0.00001],减少身体约束率[RR=0.33,95%CI(0.28,0.39),P<0.00001],缩短身体约束时间[MD=-15.93,95%CI(-21.97,-9.90),P<0.00001],降低皮肤损伤率[RR=0.33,95%CI(0.24,0.44),P<0.00001],提升护理满意度[RR=1.19,95%CI(1.13,1.24),P<0.00001]。结论我国ICU患者进行缩减约束方案可以有效降低身体约束率,缩短身体约束时间,减少非计划拔管率,减轻皮肤损害率,提升护理满意度,值得临床应用。Objective To systematically evaluate the effect of restraint reduction program on physical restraint intervention in patients in intensive care unit.Methods PubMed,Web of Science,Embase,The Cochrane Library,CNKI,VIP,Wanfang Data and CBM databases were searched by computer for randomized controlled trials on the use of restraint reduction program in ICU patients from the establishment of the database to April 30,2023.Two researchers independently screened and extracted data according to the Cochrane system evaluation method,and evaluated the risk of bias of the included literature.Meta-analysis was performed on the literature that met the inclusion criteria using RevMan 5.3 software.Results A total of 12 studies involving 3250 patients were included.The results of Meta-analysis showed that compared with conventional physical restraint care,the restraint reduction program could reduce the unplanned extubation rate[RR=0.30,95%CI(0.20,0.46),P<0.00001],reduce the physical restraint rate[RR=0.33,95%CI(0.28,0.39),P<0.00001],shorten the physical restraint time[MD=-15.93,95%CI(-21.97,-9.90),P<0.00001],reduce the rate of skin injury[RR=0.33,95%CI(0.24,0.44),P<0.00001],and improve the nursing satisfaction[RR=1.19,95%CI(1.13,1.24),P<0.00001].Conclusion The restraint reduction program for ICU patients in China can effectively reduce the physical restraint rate,shorten the physical restraint time,reduce the unplanned extubation rate,reduce the skin damage rate,and improve the nursing satisfaction,which is worthy of clinical application.

关 键 词：身体约束 缩减约束方案 ICU 

分 类 号：R473[医药卫生—护理学]