临床路径应用于小儿支气管肺炎疗效的Meta分析

Application effect of clinical pathways in children with bronchopneumonia： a Meta-analysis

目的系统评价临床路径应用于小儿支气管肺炎的疗效。方法计算机检索PubMed、CochraneLibrary、Webof Knowledge、万方、维普中文科技期刊全文数据库、中国知网期刊全文数据库，所有数据库均检索至2014年3月。查找临床路径应用于d,JL支气管肺炎的随机对照试验，使用RevMan5．2软件进行Meta分析。结果最终纳入6个研究，患儿共24559例，临床路径组12269例，传统治疗组12290例。Meta分析结果显示，通过临床路径管理，不仅缩短了支气管肺炎患儿住院天数[MD=-1．21，95％CI（-1．95，-0．48），P=0．001]，而且还降低了住院总费用[SMD=-3．68，95％CI（-5．04，-2．32），P〈0．0001]，减少抗生素使用天数[MD=-1．20，95％CI（-1．51，-0．89），P〈0．00001]，进一步提高了患儿的治愈率[OR=1．67，95％CI（1．03，2．77），P=0．04]和患者满意度[OR=6．12，95％C1（3．12，12．04），P〈0．00001]。结论临床路径应用于d,JL支气管肺炎管理，效果明显优于传统治疗流程，具有可行性和实用价值。

Objective To evaluate the application effect of clinical pathways （CP） in children with bronchopneumonia. Methods The literature of randomized controlled trials （RCTs） in children with bron- chopneumonia were retrieved by searching PnbMed, Cochrane Library, Web of Knowledge, Wanfang data- base,VIP,and CNKI from their inception date to March 2014. Meta-analysis was performed by Revman 5.2 software. Results Six RCTs involving 24 559 patients were finally selected,with 12 269 cases in the CP group and 12 290 cases in the traditional treatment group. The results of Meta-analysis showed that there were significant differences between the CP group and the traditional treatment group in the cure rate E OR = 1.67, 95 % CI （ 1.03,2. 77 ）, P = 0. 04 ], length of hospital stay I MD = - 1.21,95 % CI （ - 1.95, - 0. 48 ）, P = 0. 001 ] , hospitalization expenses [ SMD = - 3.68,95 % CI （ - 5.04, - 2.32）, P 〈 0. 0013 1 ] , days of antibiotic using E MD = - 1.20,95 % CI （ - 1.51, - 0. 89 ）, P 〈 0. 000 01 ] and patient satisfaction [ OR = 6. 12,95 % CI （ 3. 12,12. 04 ）, P 〈 0. 000 01 ]. Conclusion CP is superior compared with the traditional treatment for bron- chopneumonia, and is worthy of spread in clinical.