随访服务对重症患者影响的Meta分析

doi:10.3761/j.issn.0254-1769.2021.03.009

摘要/Abstract

摘要：

目的评价随访服务对重症患者的影响。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方和中国生物医学文献数据库有关随访服务对重症患者影响的随机对照试验。检索时限为建库至2020年5月,由2名经过培训的研究人员独立筛选文献、评价文献质量和提取资料,并采用RevMan 5.3进行Meta分析。结果最终纳入25篇文献,共5 134例患者。Meta分析结果显示,与常规护理组相比,随访服务能提高重症患者健康调查简表中精神健康维度评分[WMD=2.03,95%CI（0.27,3.79）,P=0.020]、认知评分[SMD=1.13,95%CI（0.91,1.36）,P<0.001],降低患者的医院焦虑抑郁量表中抑郁维度评分[WMD=-0.96,95%CI（-1.88,-0.04）,P=0.040],且能降低患者创伤后应激障碍发生率[RR=0.79,95%CI（0.66,0.94）,P=0.007]和创伤后应激障碍评分[SMD=-0.26,95%CI（-0.46,-0.06）,P=0.010]。结论随访服务能降低重症患者创伤后应激障碍发生风险,减轻抑郁症状,改善其精神健康和认知状况。

关键词: 危重病, 随访, ICU后综合征, Meta分析, 循证护理学

Abstract: Objective To explore the effect of follow-up on critically ill patients. Methods PubMed，Embase，Cochrane Library，Web of Science，CNKI，WanFang Data and Sinomed were searched for randomized controlled trials about follow-up among critical care patients published from inception to May 2020. 2 trained researchers screened the literature，evaluated the quality and extracted data independently，and the meta-analysis was implemented with RevMan 5.3. Results A total of 25 RCTs including 5 134 patients were included in this meta analysis. The results showed that follow up could increase critical care patients' SF 36 MCS scores[WMD=2.03，95%CI（0.27，3.79），P=0.020]，cognition scores[SMD=1.13，95%CI（0.91，1.36），P< 0.001]，decrease patients' HADS Depression scores[WMD=-0.96， 95%CI（-1.88，-0.04），P=0.040] and reduce the occurrence risk of PTSD[RR=0.79，95%CI（0.66，0.94），P=0.007] and PTSD score[SMD=-0.26，95%CI（-0.46，-0.06），P=0.010]. Conclusion ICU follow up services could reduce the risk of PTSD，alleviate depressive symptoms，and improve patients' mental health and cognitive status.

Key words: Critical Illness, Follow-Up, Post-Intensive Care Syndrome, Meta-Analysis, Evidence-Based Nursing

姚丽, 曾林, 王盛均, 杨丽平, 张志刚. 随访服务对重症患者影响的Meta分析[J]. 中华护理杂志, 2021, 56(3): 368-375.

YAO Li, ZENG Lin, WANG Shengjun, YANG Liping, ZHANG Zhigang. Effects of follow-up services on critically ill patients after ICU：a meta-analysis[J]. Chinese Journal of Nursing, 2021, 56(3): 368-375.

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