ICU转出患者睡眠障碍发生率的系统评价

doi:10.3761/j.issn.0254-1769.2023.06.015

摘要/Abstract

摘要：

目的系统评价ICU转出患者睡眠障碍的发生率，为早期预防ICU转出患者发生睡眠障碍提供理论依据。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、CINAHL、中国生物医学文献数据库、中国知网、万方数据库和维普数据库，检索时限为建库至2022年6月，由2名研究者独立根据纳入和排除标准筛选文献，采用纽尔卡斯-渥太华量表（Newcastle-Ottawa Quality Scale，NOS）对纳入文献进行质量评价，采用Stata SE.12软件进行数据分析。结果共纳入28篇文献，共3 170例患者。ICU转出患者主观睡眠障碍总体发生率为51.84%[95%CI（45.17%~58.51%）]。亚组分析结果显示，ICU转出1个月内、1~3个月、>3~6个月和>6个月，主观睡眠障碍发生率分别为50.51%[95%CI（40.97%~60.05%）]、53.34%[95%CI(44.86%~61.82%)]、49.44%[95%CI（32.71%~66.16%）]、29.55% [95%CI（13.28%~45.82%）]。单个协变量Meta回归分析结果显示，样本量、国家与该研究的异质性有关（P<0.05）。结=论 ICU转出患者睡眠障碍发生率较高，护理人员应尽早采取相关预防措施，加强对患者睡眠教育的指导，降低睡眠障碍发生率。

关键词: 睡眠障碍, ICU转出患者, 发生率, 系统评价, 护理

Abstract:

Objective To systematically evaluate the prevalence of sleep disorders and provide evidence for early prevention of sleep disorders in post-ICU patients. Methods PubMed，Embase，Web of Science，the Cochrane Library，CINAHL，CBM，CNKI，WanFang Data and VIP were searched from inception to June 2022. There were 2 researchers who independently screened the literature and assessed the quality of included studies using Critical Appraisal Tools published by Newcastle-Ottawa Quality Scale（NOS）. The meta-analysis was performed by StataSE.12 software. Results A total of 28 studies were included in this study with a total of 3 170 patients. The prevalence of subjective sleep disorders by random effects model was 51.84%[95%CI（45.17%~58.51%）]. The results of subgroup analysis showed that the prevalence of subjective sleep disorders within 1 month，1~3 months，>3~6 months and >6 months after ICU discharge was 50.51%[95%CI（40.97%~60.05%）]、53.34%[95%CI（44.86%~61.82%）]、49.44%[95%CI（32.71%~66.16%）]、29.55%[95%CI（13.28%~45.82%）]，respectively. Meta regression results of single covariate showed that sample size and country were related to heterogeneity（P<0.05）. Conclusion The prevalence of sleep disorders in post-ICU patients is high. Nursing staff should take relevant interventions，strengthen sleep health education and guidance for patients，and reduce the incidence.

Key words: Sleep Disorders, Post-ICU Patient, Prevalence, Systematic Review, Nursing Care

宋秀秀, 吴娟, 王逸楠. ICU转出患者睡眠障碍发生率的系统评价[J]. 中华护理杂志, 2023, 58(6): 743-750.

SONG Xiuxiu, WU Juan, WANG Yinan. Prevalence of sleep disorders in post-ICU patients： a systematic review[J]. Chinese Journal of Nursing, 2023, 58(6): 743-750.

图/表 6

图1 检索策略

Figure 1 Search strategies

图2 文献检索流程图

Figure 2 Flow chart of literature selection

表1 纳入主观睡眠障碍研究基本特征（n=23）

Table 1 Characteristics of the included studies on subjective sleep disorders（n=23）

续表1 纳入主观睡眠障碍研究基本特征（n=23）

Table 1（Continued） Characteristics of the included studies on subjective sleep disorders（n=23）

表2 ICU转出患者睡眠障碍的Meta回归结果

Table 2 Meta-regression results of sleep disorders in post-ICU patients

表3 ICU转出患者睡眠障碍亚组分析结果

Table 3 Subgroup analysis results of sleep disorders in post-ICU patients

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