中国手术室护士职业性肌肉骨骼疾病患病率的Meta分析

Meta-analysis of the prevalence rate of work-related musculoskeletal disorders in operation room nurses in China

目的了解我国手术室护士肌肉骨骼疾病的患病情况,为对其开展治疗和预防提供参考依据。方法计算机检索CNKI、维普期刊资源整合服务平台(VIP)数据库、万方数据知识服务平台、中国生物医学文献数据库、PubMed、Web of Science等数据库中关于我国手术室护士肌肉骨骼疾病患病率的调查研究类文献,检索时间限定为建库至2017年12月31日。由2名研究人员按照指定的文献入选和排除标准独立筛选文献合提取文献作者、发表时间、总样本量、患病人数、患病率等资料,用澳大利亚JBI循证卫生保健中心描述性研究的评价标准评价入选文献质量,用Stata14.0软件进行Meta分析。结果共纳入10篇文献,3篇A级,7篇B级,合并样本量2374例。Meta分析显示:我国手术室护士肌肉骨骼疾病的患病率87%(95%CI:83%-91%),腰部患病率最高(73%,95%CI:68%-77%),其次为颈部患病率(66%,95%CI:57%-76%)、肩部合并患病率(57%,95%CI:49%-66%)。亚组分析显示:我国手术室护士肌肉骨骼疾病的患病率随着护士年龄、工龄的增加而升高,护士每日工作时间超过8h者患病率(92%,95%CI:89%-95%)高于每天工作少于8h者患病率(79%,95%CI:72%-85%),夜班护士患病率(84%,95%CI:74%-93%)高于未参与夜班轮值护士患病率(68%,95%CI:50%-86%)。结论我国手术室护士肌肉骨骼疾病的患病率较高,以腰部、颈部、肩部的肌肉骨骼疾病患病率最高,年龄较大、工龄增加、每日参与护理工作时间和是否参与轮值夜班工作是其高危因素。

Objective To understand the prevalence of musculoskeletal diseases among nurses in operation rooms in China, and to provide reference for their treatment and prevention. Methods CNKI (China National Knowledge Infrastructure) , VIP (China Science and Technology Journal Database) , Wangfang Data Knowledge service platform, CMB disc (China Biology Medicine disc) , PubMed, Web of Science and other databases are searched by computer. The searching time is limited to the 31st of December 2017. Two researchers independently screened the literature according to the selected and excluded criteria. The authors, publishing time, total sample size, number of patients and morbidity of the literature were extracted. The quality of the selected literature was evaluated by the evaluation criteria of descriptive study of JBI Evidence-based Health Care Center in Australia. Meta analysis was performed by Stata 14.0 software. Results Totally 10 studies were retrieved, including 3 A Class and 7 B Class, and 2 374 samples were include. Results of Meta-analysis showed that the prevalence rate of musculoskeletal disorders in nurses in the operation room was 87% (95%CI: 83.0%-91.0%) . The prevalence of waist was the highest (73%, 95%CI: 68%-77%) , followed by neck prevalence (66%, 95%CI: 57%-76%) and shoulder joint morbidity (57%, 95%CI: 49%-66%) . The results of subgroup analysis showed that the incidence of musculoskeletal disease in operation room nurses increased with the age of nurses and working years. The prevalence rate in nurses working longer than 8 hours per day was 92% (95%CI: 89%-95%) , which was higher than that in nurses working less than 8 hours per day by 79% (95%CI: 72%-85%) . The prevalence rate of night shift nurses was 84%, (95%CI: 74%-93%) , which was significantly higher than that of nurses who did not work at night shift (95%CI: 50%-86%) . Conclusions The prevalence rate of musculoskeletal disease in operation room nurses in China is high. The morbidity of musculoskeletal diseases in waist, neck and shoulder is the highest. Older age, longer working years, daily nursing working hours and whether to take part in night shift work are the high risk factors.