摘要
[目的]以网状Meta分析方法评价纳入的6种强化护理干预措施对重症监护室(ICU)住院病人谵妄影响效果。[方法]计算机检索PubMed、EMbase、The Cochrane Library、CBM、CNKI和Wanfang数据库,检索强化护理(各种干预措施)与常规护理ICU住院病人的随机对照试验(RCT),检索时限均为从建库至2017年4月。由2名评价员独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用StataSE 12.0软件进行数据分析。[结果]共纳入21项RCT,包括2 237例ICU发生谵妄病人。网状Meta分析结果显示:在常规护理的基础上,治愈方面针对性护理措施优于其他,差异有统计学意义;在健康程度评分(APACHEⅡ)方面,增加家属探视时间+认知功能锻炼,增加家属探视时间+认知功能锻炼+音乐疗法,在护理措施干预后差异有统计学意义;在重症监护谵妄筛查检查表(ICDSC)方面,增加家属探视时间+认知功能锻炼,差异有统计学意义;在ICU接受监护的平均时间方面,增加家属探视时间+认知功能锻炼,增加家属探视时间+认知功能锻炼+音乐疗法,差异有统计学意义。[结论]纳入研究的6种强化护理干预措施在护理ICU住院病人谵妄中优于常规护理措施,网状Meta结果显示,基于各结局指标,增加家属探视时间+认知功能锻炼+常规护理的联合共同干预,较其他5种强化护理措施相对有效。受纳入研究数量和质量的限制,本研究结论尚需开展更多高质量研究予以证实。
Objective：To evaluate the effect of 6 intensive nursing interventions on delirium in ICU inpatients by Network Meta-analysis.Methods：Database including PubMed,EMbase,The Cochrane,CBM,Library CNKI and Wanfang Data were searched from inception to April 2017,collect the intensive nursing care（various interventions）on routine nursing ICU randomized controlled trial of hospitalized patients（RCT）.The data were analyzed by StataSE 12 software after 2 reviewers independently screened documents,extracted data and evaluated the bias risk.Results：Paticipants included 21 randomized controlled trias with a total of 2 237 ICU inpatients with delirium.Network Meta-analysis showed that the cure on the basis of routine nursing,nursing care is better than the other,the difference was statistically significant;health score（APACHE II）,increased visitation time＋Exercise cognitive function,increase visitation time＋Exercise＋cognitive function of music therapy in nursing intervention of difference the measures have statistical significance;in the intensive care delirium screening checklist（ICDSC）,increased visitation time＋Exercise cognitive function was statistically significant;the average time of acceptance monitoring during the ICU（d）side,increased visitation time＋Exercise cognitive function,increased visitation time＋cognitive function exercise＋music therapy.There was statistical significance.Conclusions：6 intensive nursing intervention in hospitalized patients than routine nursing measures in delirium in nursing ICU included in the study,Network Meta results showed that the various outcome measures based on joint intervention increased visitation time＋cognitive function exercise and routine nursing care,compared to the other 5 kinds of effective nursing measures is relatively strong.Due to the limitation of the quantity and quality of the study,the conclusions of this study need to be confirmed by more high quality research.
作者
杨丽
李敏
李亚男
田金徽
Yang Li;Li Min;Li Yanan(The First People＇s Hostipal of Lanzhou City,Gansu 730050 Chin)
出处
《循证护理》
2018年第5期394-399,共6页
Chinese Evidence-Based Nursing
