在上消化道出血急救中应用循证护理和预见性护理的Meta分析

Applications of Evidence-based Nursing and Forecasting Nursing in Emergency Treatment of Upper Gastrointestinal Bleeding: a system review and Meta-analysis

目的使用Meta分析评价循证护理和预见性护理在上消化道出血急救中的效果。方法检索数据库包括:中国知网、万方数据、维普、中国生物医学数据库、PubMed、MEDLINE、Cochrane、Embase等,拟定检索关键词,制定检索策略。使用纽卡斯尔-渥太华量表(the Newcastle-Ottawa scale,NOS)进行文献质量评估。在RevMan 5.3软件上进行数据处理,绘制森林图。效应指标选用RR值和95%CI,异质性检验指标为I^2和P值。进行敏感性检验,Stata 12.0软件上使用Egger’s法对文献进行发表偏倚评估。结果循证护理组与预见性护理组比较,Z=3.04(P=0.002)、RR(95%CI):1.05(1.02,1.08),差异有统计学意义(P<0.05)。敏感性分析,在分别更改效应模型、剔除低质量文献、剔除病例对照研究后,结果仍然具有统计学意义(P<0.05)。发表偏倚评估,t=0.97,P=0.343,95%CI:(-0.62,1.70),差异无统计学意义(P>0.05)。结论循证护理较预见性护理在上消化道出血止血方面有更好的效果,值得临床推广应用。

Objective Meta-analysis was used to evaluate the application of evidence-based nursing and the forecasting nursing in first aid for upper gastrointestinal bleeding. Methods The search databases included: China Knowledge Network, Wanfang Data, Weipu, China Biomedical Database, PubMed, MEDLINE, Cochrane and Embase, etc. We formulated searching key words and strategies. Literature quality assessment was performed using The Newcastle-Ottawa Scale(NOS). Data processing was conducted on RevMan 5.3 software, drawing a forest map. The effect index used RR value and 95%CI, and the heterogeneity test index was I^2 and P value. Sensitivity testing was performed and the results of the publication bias were evaluated using the Egger’s method on the Stata 12.0 software. Results Compared with the predictive nursing group, Z=3.04(P=0.002) and RR(95%CI): 1.05(1.02, 1.08) in the evidence-based nursing group showed statistical significance(P<0.05). As for sensitivity analysis, after changing the effect model, eliminating low-quality literature, and eliminating case-control studies, the results were still statistically significant(P<0.05). As for the publication bias evaluation, t=0.97, P=0.343, 95%CI:(-0.62, 1.70) indicated no statistical significance(P>0.05). Conclusion Evidence-based nursing has a better effect on the hemorrhage of upper digestive tract than forecasting nursing, and it is worthy of clinical application.