延续性护理对结直肠癌造口病人干预效果的Meta分析

Intervention effect of continuous nursing on patients with colorectal cancer stoma:a Meta-analysis

目的:系统评价延续性护理对结直肠癌造口病人的干预效果。方法:计算机检索中国知网数据库(CNKI)、维普数据库(VIP)、万方数据库(WanFang Datebase)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、EMbase、the Cochrane Library等数据库,搜集关于延续性护理干预结直肠癌造口病人的随机对照研究(RCT),根据纳入与排除标准对检索到的文献进行筛查、资料提取、文献质量评价,并采用RevMan 5.4软件进行Meta分析。结果:共纳入25篇RCT,Meta分析结果显示,延续性护理可以降低造口并发症发生率[RR=0.45,95%CI(0.27,0.74),P=0.002],提高病人的生活质量[SMD=1.46,95%CI(0.88,2.03),P<0.00001]、自我效能[MD=15.28,95%CI(7.36,23.20),P=0.0002]、造口自理能力[SMD=1.89,95%CI(1.32,2.46),P<0.00001]、造口适应水平[SMD=1.93,95%CI(0.81,3.05),P=0.0007],缓解造口病人的焦虑情绪[SMD=-0.85,95%CI(-1.08,-0.62),P<0.00001]。结论:现有证据表明,延续护理应用于结直肠癌造口病人,可以降低造口并发症发生率,提高病人的生活质量、自我效能、造口自理能力及造口适应水平,缓解造口病人的焦虑情绪。

Objective:To systematically evaluate the intervention effect of continuous nursing on colorectal cancer patients with colostomy.Methods:Randomized controlled studies(RCTs)on continuous nursing intervention for patients with colorectal cancer stoma were retrieved from CNKI,VIP,WanFang Datebase,CBM,PubMed,Web of Science,EMbase,the Cochrane Library and other databases.According to the inclusion and exclusion criteria,the retrieved documents are screened,the data is extracted,and the quality is evaluated.RevMan 5.4 software was used for Meta-analysis.Results:A total of 25 RCTs were included.Meta-analysis results showed that continuous care can reduce the incidence of stoma complications[RR=0.45,95%CI(0.27,0.74),P=0.002],and improve the life quality of patients[SMD=1.46,95%CI(0.88,2.03),P<0.00001],self-efficacy[MD=15.28,95%CI(7.36,23.20),P=0.0002],stoma self-care ability[SMD=1.89,95%CI(1.32,2.46),P<0.00001],stoma adaptation level[SMD=1.93,95%CI(0.81,3.05),P=0.0007],relieve the anxiety of patients with stoma[SMD=-0.85,95%CI(-1.08,-0.62),P<0.00001].Conclusion:Existing evidence shows that continuous nursing has a positive impact on the multiple outcomes of patients with colorectal cancer stoma.It can reduce the incidence of stoma complications,improve the patient's quality of life,self-efficacy,self-care ability and stoma adaptation level,and relieve the anxiety of stoma patients.