文章摘要

循证护理预防加强监护病房患者呼吸机相关性肺炎效果的 Meta 分析

作者: 1徐慧敏, 1丁蓉, 1顾保娣
1 盐城市第一人民医院神经内科,江苏 盐城 224000
通讯: 丁蓉 Email: 15366552890@163.com
DOI: 10.3978/j.issn.2095-6959.2019.03.025

摘要

目的:探讨循证护理(evidence-based nursing,EBN)应用于加强监护病房(intensive care unit,ICU)机械通气患者预防呼吸机相关性肺炎(venti lator associated pneumonia,VAP)的效果。方法:利用计算机检索数据库PubMed,Web of Science,Cochrane图书馆,中国知网,维普网,万方数据等资源,收集有关EBN预防VAP的随机对照试验(randomized controlled trials,RCT)文献,数据分析运用Rev Man 5.3软件统计。结果:纳入文献10篇。分析结果显示:相对于常规护理,EBN可降低VAP发生率(RR =0.35,95%CI 0.26~0.48,P<0.00001)、延长发生时间(MD=3.78,95%CI 2.79~4.78,P<0.00001)、缩短机械通气时间(MD=−7.03,95%CI −9.64~−4.42,P<0.00001),而对缩短住院时间效果并不明显。Egger检验P=0.003显示有发表偏倚。结论:EBN可降低ICU机械通气患者VAP的发生率,延长其发生时间,缩短机械通气时间,但存在纳入文献数量及质量偏低,仍需大样本多中心高质量的临床RCT研究进一步验证。
关键词: 循证护理;呼吸机相关性肺炎;加强监护病房;Meta分析

Effect of evidence-based nursing on preventing ventilator associated pneumonia in intensive care unit patients: A Meta-analysis

Authors: 1XU Huimin, 1DING Rong, 1GU Baodi
1 Department of Neurology, Yancheng City No.1 People’s Hospital, Yancheng Jiangsu 224000, China

CorrespondingAuthor: DING Rong Email: 15366552890@163.com

DOI: 10.3978/j.issn.2095-6959.2019.03.025

Abstract

Objective: To explore the effect of evidence-based nursing (EBN) on the prevention of ventilator-associated pneumonia (VAP) in the intensive care unit (ICU) patients with mechanical ventilation. Methods: The randomized controlled trials (RCTs) on EBN in preventing VAP were searched the PubMed, WEB of Science, Cochrane library, China National Knowledge Infrastructure (CNKI), Wanfang Periodical Databases and Chinese Science and Technology Periodical Databases (VIP), data were analyzed by RevMan 5.3 software. Results: Ten RCTs were included in the study. Meta-analysis results showed that the EBN reduced the incidence of VAP (RR =0.35, 95%CI 0.26 to 0.48, P<0.00001), prolonged occurrence time (MD=3.78, 95%CI 2.79 to 4.78, P<0.00001), shorten the mechanical ventilation duration (MD=−7.03, 95%CI −9.64 to −4.42, P<0.00001], but the effect on shortening the length of hospitalization was not obvious. Egger’s test showed a publication bias of the RCTs retrieved (P=0.003). Conclusion: EBN can reduce the incidence of VAP, prolong the time of occurrence and shorten the mechanical ventilation duration, but it still needs to be further verified by large sample, multicenter and high quality clinical RCT study.
Keywords: evidence-based nursing; ventilator associated pneumonia; intensive care unit; Meta-analysis