摘要
目的对基于Roy适应模式的护理干预应用于ICU机械通气患者的相关文献进行系统评价,证实其应用效果,为临床实践提供参考。方法计算机检索PubMed、Cochrane Library、Embase、Ebsco、Elsevier、CNKI、Wanfang Data、VIP和CBM的随机对照试验(RCTs)和半随机对照试验(CCTs),检索时间为建库至2020年5月。干预组应用以Roy适应模式为基础的护理干预,对照组实施常规护理干预,观察干预后两组脱机成功率、呼吸机天数、住院天数以及住院费用。由2名研究员进行文献筛选、资料提取及质量评价后,利用RevMan 5.3软件进行meta分析。结果最终纳入6篇研究,共660例,质量评价结果均为B级。meta分析结果显示:干预组较对照组可提高脱机成功率[RR=1.27,95%CI(1.16,1.38),P<0.00001];降低呼吸机天数[MD=-3.88,95%CI(-4.15,-3.61),P<0.00001];降低住院天数[MD=-3.13,95%CI(-3.74,-2.52),P<0.00001];减少住院费用[MD=-0.04,95%CI(-0.08,-0.02),P<00.00001]。结论对ICU机械通气患者实施基于Roy适应模式的护理干预效果优于常规护理。但纳入文献质量不高,样本量大小与临床干预措施标准不一,需要开展大样本、多中心临床标准化研究进一步证实。
Objective To systematically reviewed the relevant literature on the application of Roy-based adaptive nursing intervention in patients with mechanical ventilation in intensive care unit(ICU)to confirm its application effect and provide reference for clinical practice.Methods Computer searched for PubMed,Cochrane Library,Embase,Ebsco,Elsevier,CNKI,Wanfang Data,VIP and CBM randomized controlled trials(RCTs)and semi-randomized controlled trials(CCTs),the retrieval time was from the establishment to May 2020.The intervention group received nursing intervention based on Roy adaptation model,and the control group received routine nursing intervention.The off-line success rate,ventilator days,hospitalization days and hospitalization costs were observed after intervention.After literature screening,data extraction and quality assessment by two researchers,meta-analysis was performed using RevMan 5.3 software.Results In the end,six studies were included with a total of 660 patients,and the quality evaluation results were all grade B.Meta-analysis results showed that the intervention group could improve the success rate of patients of-fline compared with the control group(RR=1.27,95%CI[1.16,1.38],P<0.00001);decrease ventilator days(MD=-3.88,95%CI[-4.15,-3.61],P<0.00001);reduce the patient length of hospital stay(MD=-3.13,95%CI[-3.74,-2.52],P<0.00001);reduce hospital costs(MD=-0.04,95%CI[-0.08,-0.02],P<0.00001).Conclusion The effect of Roy-based adaptive nursing intervention on ICU patients with mechanical ventilation is better than conventional nursing.However,the quality of the included literatures is not high,and the sample size is different from the standard of clinical intervention measures.Therefore,large-sample,multi-center standardized clinical studies need to be carried out for further confirmation.
作者
康艳楠
王瑞瑞
杨婷
张春梅
KANG Yannan;WANG Ruirui;YANG Ting;ZHANG Chunmei(School of Nursing,Tianjin University of Traditional Chinese Medicine,Tianjing301617,China)
出处
《中国医药导报》
CAS
2021年第4期163-167,共5页
China Medical Herald
基金
国家自然科学基金资助项目(71704133)。
关键词
重症监护室
机械通气
ROY适应模式
系统评价
Intensive care unit
Mechanical ventilation
Roy adaptation model
Systematic review
