心肌梗死并发心力衰竭患者循证护理的Meta分析

Influence of Evidence-based nursing for patients with myocardial infarction complicated with heart failure:a systematic review

目的对循证护理(EBN)应用于心肌梗死并发心力衰竭患者的效果进行Meta分析。方法计算机检索PubMed、Medline、Web of Science、万方、维普、CNKI及GBM数据库,选取建库至2017年6月收录的关于EBN在我国心肌梗死并发心力衰竭患者中应用的文献。由2位评价员筛选文献,提取相关资料,采用RevMan 5.3软件进行Meta分析。结果共26个RCT纳入本Meta分析,试验组(EBN)1382例,对照组(常规护理组)1380例。试验组在死亡率、并发症发生率方面显著低于对照组[OR=0.23,95%CI(0.17,0.31),P<0.00001;OR=0.31,95%CI(0.21,0.45),P<0.00001],在护理质量的满意率方面与对照组相比,均显著增高[OR=5.43,95%CI(3.87,7.63),P<0.00001]。结论 EBN能降低心肌梗死并发心力衰竭患者的死亡率及并发症发生率,可以提高护理质量的满意率。

Objective To evaluate the therapeutic effect of Evidencebased nursing （EBN） on myocardial infarction complicated with heart failure by Metaanalysis. Method A literature search of PubMed, Medline, Web of Science, Wanfang, VIP, CNKI and China Bio Medicine （CBM） databases were conducted to identify relevant clinical controlled trials. The retrieval time was from inception to June 2017. Two reviewers independently screened literature, extracted data. Then data was analyzed by RevMan 5.3 software. Results 26 clinical controlled trials were assessed, which including 1382 patients in the observation group （EBN） and 1380 patients in the control group （routine nursing pathway）. Compared with routine nursing pathway, the EBN could decrease death rate, the complication incidence rate［OR=0.23, 95%CI （0.17,0.31）, P＜0.00001; OR=0.31, 95%CI （0.21,0.45）, P＜0.00001］. Nursing satisfaction was significantly better than those of the control group［OR=5.43, 95%CI （3.87,7.63）, P＜0.00001］. Conclusion EBN could decrease death rate, the complication incidence rate and improve nursing satisfaction.