早期康复活动对机械通气重症患者预后影响的Meta分析

Effect of early mobilization on prognosis of patients with mechanical ventilation:a meta-analysis

目的系统评估早期康复活动对机械通气重症患者总体预后的影响。方法通过计算机检索Pub Med、MEDLINE、Web of Science、Springer、Coc hrane图书馆、CNKI、万方等数据库,收集到相关的文献,根据Cochrane reviewers手册5.0筛选文献、提取资料、评价文献质量,使用Stata 12.0软件进行Meta分析。结果本文纳入22篇随机对照研究,总样本量1 983例(实验组1 017例,对照组966例),Meta结果显示,早期康复活动可以明显减少患者入住ICU时间(WMD=-2.279,95%CI:-3.315～-1.244,P<0.05)、总的住院时间(WMD=-4.091,95%CI:-6.334～-1.848,P<0.05)、机械通气时间(WMD=-2.756,95%CI:-4.067～-1.444,P<0.05),而ICU病死率、总的病死率、出院后回家率均未见明显差异(均P>0.05)。结论早期康复活动对机械通气的重症患者是安全的,并且可以明显改善患者总体预后。

Objective To evaluate the effect of early mobilization on the prognosis of patients undergoing mechanicalventilation in intensive care unit. Methods The databases PubMed, MEDLINE, Springer, the Cochrane Library, CNKI, andWanFang data were systematically searched. According to the manual 5.0 Cochrane, reviewers screened the literature,extracted data, evaluate the quality of the literature, and then the meta-analysis was conducted by using stata11.0Meta-analysis software. Results There were 22 random controlled trials were included in this meta-analysis, with 1983cases. The pooled results showed that the early mobilization appeared to have positive effect on the length of ICU stay（WMD=-2.279, 95%CI-3.315--1.244, P〈0.05）, total length of hospital stay （WMD=-4.091, 95%CI：-6.334--1.848, P〈0.05） andduration of mechanical ventilation （WMD=-2.756, 95%CI：-4.067--1.444, P〈0.05）. But there was no significant difference in themortality at hospital and ICU （all P〉0.05）. Conclusion Early mobilization has positive effect on patients with mechanical ventilationin ICU, and it can improve the prognosis of patients.