虚拟现实暴露在手术患儿中应用效果的Meta分析

doi:10.3761/j.issn.0254-1769.2024.24.015

摘要/Abstract

摘要：

目的系统评价虚拟现实暴露在手术患儿中的应用效果，为临床实践提供依据。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、中国知网、维普数据库、万方数据库和中国生物医学文献数据库，搜集关于虚拟现实暴露在手术患儿中应用效果的随机对照试验。检索时限为建库至2024年3月21日。2名研究者独立进行文献筛选、数据提取及质量评价，采用RevMan 5.4软件进行Meta分析。结果纳入9篇文献，共900例患儿。Meta分析结果显示，使用虚拟现实暴露后试验组术前焦虑水平低于对照组，差异具有统计学意义[SMD=-0.65， 95%CI（-0.95，-0.35），P<0.001]；试验组照顾者满意度高于对照组，差异具有统计学意义[SMD=0.40，95%CI（0.10， 0.70），P=0.010]；但两组术后疼痛程度比较，差异无统计学意义[SMD=-1.16，95%CI（-2.83，0.51），P=0.180]。亚组分析结果显示，与普通虚拟现实视频及普通交互式虚拟现实视频比较，采用游戏化交互式虚拟现实视频进行干预时，患儿术前焦虑水平较低[SMD=-0.96，95%CI（-1.36，-0.56），P<0.001]；与干预时长≤4 min比较，干预时长为5 min时，患儿术前焦虑水平较低[SMD= -0.96，95%CI（-1.36，-0.56），P<0.001]。结论实施虚拟现实暴露能够有效缓解患儿术前焦虑情绪，提高照顾者满意度，但对患儿术后疼痛程度的影响仍需进一步研究。

关键词: 虚拟现实暴露, 焦虑, 疼痛, 满意度, Meta分析, 围手术期护理, 儿科护理学

Abstract:

Objective To systematically evaluate the application effect of virtual reality exposure in children undergoing surgery，providing guidance for clinical practice. Methods A systematic search of PubMed，Web of Science，Cochrane Library，Embase，CNKI，VIP，WanFang Data and CBM was conducted for randomised controlled trials on the effects of virtual reality exposure in children undergoing surgery. The search time was limited to March 21，2024. There were 2 researchers who independently screened the literature，extracted data and evaluated quality. Meta-analysis was performed using RevMan 5.4 software. Results A total of 9 studies with 900 children were included. The results of Meta-analysis showed that the level of preoperative anxiety in the experimental group was lower than that in the control group，and the difference was statistically significant[SMD=-0.65，95%CI（-0.95，-0.35），P<0.001]. The caregiver satisfaction in the experimental group was higher than that in the control group，and the difference was statistically significant[SMD=0.40，95%CI（0.10，0.70），P=0.010]. However，there was no statistically significant difference when comparing the level of postoperative pain between the 2 groups[SMD=-1.16， 95%CI（-2.83，0.51），P=0.180]. Subgroup analyses showed that the preoperative anxiety levels of the children were lower when the intervention was performed with gamified interactive virtual reality videos compared with ordinary virtual reality videos and ordinary interactive virtual reality videos[SMD=-0.96，95%CI（-1.36，-0.56），P<0.001]. Compared with ≤4 min, children had lower levels of preoperative anxiety when the length of the intervention was 5 min[SMD=-0.96，95%CI（-1.36，-0.56），P<0.001]. Conclusion The implementation of virtual reality exposure was effective in relieving preoperative anxiety and improving caregiver satisfaction，but further research is needed to investigate the effect on the children’s postoperative pain levels.

Key words: Virtual Reality Exposure, Anxiety, Pain, Satisfaction, Meta-Analysis, Perioperative Nursing, Pediatric Nursing

胡芷蘐, 姚洁, 张政香, 李晓伟, 郭妍. 虚拟现实暴露在手术患儿中应用效果的Meta分析[J]. 中华护理杂志, 2024, 59(24): 3041-3048.

HU Zhixuan, YAO Jie, ZHANG Zhengxiang, LI Xiaowei, GUO Yan. Effectiveness of virtual reality exposure in surgical children：a Meta-analysis[J]. Chinese Journal of Nursing, 2024, 59(24): 3041-3048.

图/表 8

图1 PubMed检索策略

Figure 1 PubMed search strategy diagram

图2 文献筛选流程

Figure 2 Flow chart of literature screening process

表1 纳入文献的基本特征（n=9）

Table 1 Descriptive characteristics of the included studies（n=9）

表2 文献质量评价结果（n=9）

Table 2 Quality evaluation results of the included studies（n=9）

图3 虚拟现实暴露对手术患儿术前焦虑水平的影响 1)进入手术室前;2)麻醉诱导前。

Figure 3 Effect of virtual reality exposure on preoperative anxiety levels in surgical children

表3 虚拟现实暴露对手术患儿术前焦虑水平影响的亚组分析

Table 3 Subgroup analysis of the effect of virtual reality exposure on preoperative anxiety levels in surgical children

图4 虚拟现实暴露对手术患儿术后疼痛程度的影响

Figure 4 Effect of virtual reality exposure on postoperative pain levels in surgical children

图5 虚拟现实暴露对手术患儿照顾者满意度的影响

Figure 5 Effect of virtual reality exposure on caregiver satisfaction of surgical children

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