我国脑瘫患儿延续性护理干预效果的Meta分析

Meta-analysis of effect of continuous care intervention for children with cerebral palsy in China

[目的]评价延续性护理模式在脑瘫患儿中的应用效果。[方法]计算机检索PubMed、中国期刊全文数据库(CNKI)、万方数据库(Wanfang Data)、中国生物医学服务系统(CBM)和中文科技期刊全文数据库(VIP)等数据库,收集有关延续性护理模式应用于脑瘫患儿的随机对照试验。根据纳入和排除标准,对文献进行筛选,提取数据并进行文献质量评价,采用RevMan5.3软件进行Meta分析。[结果]最终纳入19篇随机对照试验,共计2145例病人。Meta分析结果显示,延续性护理康复组与常规康复组相比,脑瘫患儿的日常生活能力明显改善,Barthel评分均显著高于对照组,差异有统计学意义(P<0.05);以脑瘫量表评分为评价指标时,延续性护理康复组评分显著高于对照组,差异有统计学意义(P<0.05);以残疾程度、PedsQLTM3.0量表为评价指标时,差异无统计学意义(P>0.05);以日常生活能力评分为评价指标时,延续性护理康复组评分显著高于对照组,差异有统计学意义(P<0.05)。[结论]延续性护理能够提高我国脑瘫患儿的日常生活能力;但在改善脑瘫患儿残疾程度和生存质量方面无明显作用,需开展临床研究做进一步验证。

Objective:To evaluate the application effect of the continuous care model in children with cerebral palsy.Methods:Relevant Randomized Controlled Trials(RCTs)of continuous care model applied for children with cerebral palsy were retrieved from PubMed,Chinese Journal Full-text Database(CNKI),Wanfang Database,China Biomedical Service System(CBM),Chinese Sci-tech Journal Full-text Database(VIP)and other databases,then to screen the literature,extract the data,and evaluate the literature quality according to the inclusion and exclusion criteria.RevMan5.3 software was used for meta-analysis.Results:A total of 19 RCTs were finally included,involving 2145 patients.The results of the meta-analysis showed that compared with the conventional rehabilitation group,the scores of Activity of Daily Living(ADL)of children with cerebral palsy were significantly improved in the continuous care rehabilitation group,and the Barthel scores were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).When the Cerebral Palsy Standardized Scale was used as the evaluation criteria,the score of the continuous care rehabilitation group was significantly higher than that in control group,and the difference was statistically significant(P<0.05).When the degree of disability and PedsQLTM3.0 scale was used as the evaluation index,the difference was not statistically significant(P>0.05);when the ADL score was used as the evaluation index,the score of the continuous care rehabilitation group was significantly higher than that in control group,and the difference was statistically significant(P<0.05).Conclusions:Continuous care could improve the ADL of children with cerebral palsy in China,while with no obvious effect in improving the disability and quality of life of children with cerebral palsy,and clinical research was required for further verification.