临床护理路径对大肠癌肠造口患者围术期影响的Meta分析

Effects of clinical nursing pathways on colorectal cancer patients with colostomy in perioperative period：a Meta-analysis

目的：系统评价临床护理路径对大肠癌肠造口患者的实施效果。方法通过中国学术期刊全文数据库（CNKI）、中文科技期刊全文数据库（VIP）、中国生物医学文献数据库（CBM）、万方等数据库,检索关于临床护理路径干预大肠癌结肠造口患者的随机对照试验（RCT）,并采用RevMan 5.3软件进行Meta分析。结果纳入16篇文献,包括1159例大肠癌肠造口患者,其中观察组582例,对照组577例。 Meta分析结果显示,观察组与对照组相比,患者护理满意度更高[RR＝1.24,95 CI％＝（1.17,1.32）,P〈0.01],患者自我护理能力更高[RR＝1.58,95 CI％＝（1.38,1.82）,P〈0.01],平均住院时间更短[SMD＝－1.65,95 CI％＝（－2.66,－0.65）,P〈0.01],平均住院费用更少[SMD＝－3.89,95 CI％＝（－6.90,－0.87）,P〈0.01],并发症发生率更低[RR＝0.39,95 CI％＝（0.27,0.55）,P〈0.01],差异均有统计学意义。观察组患者健康知识掌握率更高。结论临床护理路径在大肠癌肠造口患者中应用效果明显优于传统护理方法。

Objective To systematically review the effects of clinical nursing pathways on colorectal cancer patients with colostomy.Methods Studies on the randomized controlled trials （RCT） of clinical nursing pathways on colorectal cancer patients with colostomy were systematically searched in electronic databases including CNKI, VIP, CBM and WANFANG Data. Meta-analysis was performed using RevMan 5. 3 software. Results A total of 16 studies enrolling 1 159 patients （582 in observation group and 577 in control group） were included. The results of the Meta-analysis indicated that patients′satisfaction [RR=1.24, 95 CI%=（1.17,1.32）, P〈0.01] and self-care ability of patients [RR=1.58, 95 CI%=（1.38,1.82）, P〈0.01] were significantly higher in observation group than in control group. Average hospitalization time [ SMD=-1. 65, 95 CI%=（-2. 66,-0.65） , P〈0.01] , the medical expenses [ SMD=-3.89, 95 CI%=（-6.90,-0.87） , P〈0.01] and postoperative complications [RR=0.39, 95 CI%=（0.27,0.55）, P〈0.01] in observation group were significantly decreased while comparing to control group. The descriptive analysis showed that the mastering of health knowledge in the clinical nursing pathway group were better than those in control group.Conclusions Application effects of clinical nursing pathways are superior to the traditional nursing methods in colorectal cancer patients with colostomy.