延续性护理对胰腺炎患者生命质量影响的Meta分析

Meta-analysis of the effect of transitional care on quality of life in patients with pancreatitis

目的评价延续护理对胰腺炎患者生命质量的影响。方法计算机检索PubMed、Web of Science、Cochrane Library、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)和万方数据库,并辅助其他检索,全面收集延续性护理对胰腺炎患者生命质量影响的相关研究。采用Cochrane系统评价方法,对纳入研究进行质量评价和资料提取后,采用RevMan 5.3软件进行Meta分析。结果共纳入21篇随机对照试验,1818(910/908)例患者。简明健康调查量表(SF-36)8个维度Meta亚组分析显示,各组均为P<0.05,合并效应有统计学意义;依从性结局指标以电话为主的干预方式结果为:保持生活规律[加权均数差(WMD)值为4.33,95%可信区间(CI)2.52~7.44,P<0.01]、戒烟戒酒(WMD值为5.95,95%CI 3.69~9.59,P<0.01)、保持健康饮食(WMD值为8.62,95%CI 5.07~9.59,P<0.01),合并效应量有统计学意义;以电话干预措施为主的延续护理能够降低复发率(WMD值为0.20,95%CI 0.13~0.31,P<0.01),延续护理建立档案干预措施为主的Meta分析结果显示WMD值为0.25,95%CI 0.12~0.52,P<0.01、档案+电话的方式结果显示WMD值为0.24,95%CI 0.09~0.63,P<0.01,合并效应量有统计学意义。结论延续性护理可改善胰腺炎患者的生命质量、提高遵医嘱依从性、降低复发率,但尚需大样本、高质量、多中心随机对照试验进一步验证。

Objective To evaluate the effect of transitional care on the quality of life of patients with pancreatitis.Methods We searched the following databases such as PubMed,Web of Science,Cochrane Library,CNKI,CBM,and WanFang Data electronically.Other sources as applying were also retrieved.Comprehensive collection of continuing care on the quality of life in patients with pancreatitis related research.According to the evaluation method of Cochrane system,the quality evaluation and data extraction were carried out,and the RevMan 5.3 software was used for Meta analysis.Results A total of 21 randomized controlled trials involving 1818 patients(910/908)were included.SF-36 health survey scale,analysis of 8 Meta subgroups showed that all groups P<0.05,and the combined effect was statistically significant.The results of the intervention with telephone as the main outcome indicator were:maintaining a regular lifestyle[weight mean difference(WMD)value was 4.33,95% confidence interval(CI)2.52-7.44,P<0.01],quitting smoking and drinking(WMD value was 5.95,95%CI 3.69-9.59,P<0.01),maintaining a healthy diet(WMD value was 8.62,95%CI 5.07-9.59,P<0.01).Continuous nursing based on telephone intervention can reduce the recurrence rate(WMD value was 0.20,95%CI 0.13-0.31,P<0.01).Meta-analysis based on the intervention of establishing archives for continuous nursing showed that WMD value was 0.25,95%CI 0.12-0.52,P<0.01,and archives and telephone showed that WMD value was 0.24,95%CI 0.09-0.63,P=0.004,and the combined effect was statistically significant.Conclusions Continuous nursing can improve the quality of life of patients with pancreatitis,improve the compliance with medical advice,and reduce the recurrence rate,but it needs to be further verified by a large sample,high-quality,multi-centered randomized controlled trial.