临床护理路径在心房颤动射频消融术患者中应用效果的Meta分析

Application effects of clinical nursing pathway in patients with atrial fibrillation undergoing radiofrequency ablation:a meta analysis

目的系统评价临床护理路径应用于心房颤动(以下简称房颤)射频消融术患者的效果。方法计算机检索PubMed、EMbase、The Cochrane Library、CNKI中国期刊全文数据库、万方数据库、维普中文期刊全文数据库、中国生物医学文献数据库中关于应用临床护理路径对房颤消融术患者进行干预的临床随机对照试验(RCT),检索时限截至2018年10月。按纳入及排除标准筛选文献并进行质量评价,使用STATA13.0软件对数据进行Meta分析。结果共纳入9项随机对照试验,包含受试者1 054例,其中干预组528例,对照组526例。1篇文献质量评价为B级,其余文献均为C级。Meta分析结果显示,干预组并发症发生率低于对照组[RR=0.39,95%CI(0.28,0.55),P<0.001];干预组住院天数短于对照组[WMD=-3.56,95%CI(-4.84,-2.29),P<0.001];干预组住院费用少于对照组[WMD=-2 300.21,95%CI (-2 701.84,-1 898.57),P<0.001];干预组护理满意度高于对照组[RR=1.16,95%CI(1.04,1.30),P<0.001];干预组健康知识达标率高于对照组[RR=1.26,95%CI(1.18,1.35),P<0.001]。结论对房颤射频消融术患者行临床护理路径干预,可降低其术后并发症发生率,缩短住院天数,减少住院费用,并提高其护理满意度及疾病知识掌握程度。由于受纳入研究数量和质量所限,上述结论尚需开展更多高质量研究予以验证。

Objective To systematically evaluate the effects of clinical nursing pathway(CNP)used in the patients with atrial fibrillation(AF)undergoing radiofrequency ablation.Methods The databases including PubMed,EMbase,Cochrane Library,CNKI,WanFang,VIP and CBM data were retrieved by computer to collect the randomized controlled trials(RCT)on the intervention to the AF patients with radiofrequency ablation by using CNP.The retrieval time was until October 2018.The literatures were screened according to inclusion and exclusion criteria,and the quality evaluation was performed.Then the meta-analysis on the obtained data was performed by using STATA13.0 software.Results A total of 9 RCTs involving 1 054 subjects were included,528 cases in the intervention group and 526 cases in the control group.The quality evaluation had the B grade in one article,and the others were the C grade.The meta analysis results showed that the incidence rate of complications in the intervention group was lower than that in the control group [RR=0.39,95%CI(0.28,0.55),P<0.001],the hospitalization days in the intervention group were shorter than those in the control group[WMD=-3.56,95%CI(-4.84,-2.29),P<0.001],the hospitalization expenses in the intervention group was less than that in the control group[WMD=-2 300.21,95%CI(-2 701.84,-1 898.57),P<0.001],the nursing satisfaction in the intervention group was higher than that in the control group[RR=1.16,95%CI(1.04,1.30),P<0.001],the awareness rate of health knowledge in the intervention group washigher than that in the control group[RR=1.26,95%CI(1.18,1.35),P<0.001].Conclusion Conducting CNP in the AF patients undergoing radiofrequency ablation can reduce the incidence rate of postoperative complications,shorten the hospitalization days,reduce the hospitalization expenses,and increase the nursing satisfaction and the mastery degree of disease knowledge.But the above conclusion needs to conduct more high quality studies for verification due to the limitation of included RCT quantity and quality.