心理干预对慢性阻塞性肺疾病病人无创正压辅助通气应用效果的Meta分析

Effect of psychological intervention on non-invasive positive pressure assisted ventilation in patients with chronic obstructive pulmonary disease:a Meta-analysis

目的:系统评价心理干预对慢性阻塞性肺疾病病人无创正压辅助通气的应用效果。方法:通过计算机检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed、EMbase、the Cochrane Library、Web of Sciense等中文、英文数据库,收集所有符合标准的随机对照试验文献,对纳入文献进行质量评价和Meta分析,使用RevMan 5.3软件进行统计处理。结果:共纳入11篇随机对照试验文献,试验组480例,对照组488例。Meta分析结果显示:心理干预可有效提高慢性阻塞性肺疾病病人使用无创正压通气依从性[OR=2.84,95%CI(2.17,3.72),P<0.00001],提高病人氧分压(PaO_(2))值[MD=4.09,95%CI(3.98,4.19),P<0.00001],降低二氧化碳分压(PaCO 2)值[MD=-8.17,95%CI(-12.32,-4.02),P=0.0001]。结论:现有证据表明,心理干预能够有效提高慢性阻塞性肺疾病病人无创正压通气的依从性及改善血氧指标,选择合适的心理干预措施是提高无创正压通气依从性效果的重要因素。

Objective:To systematically evaluate the effect of psychological intervention on non-invasive positive pressure assisted ventilation in patients with chronic obstructive pulmonary disease.Methods:All randomized controlled trials that meet the standards were retrieved from Chinese and English databases including CNKI,VIP,WanFang Database,CBM,PubMed,EMbase,the Cochrane Library,Web of Sciense.The included literature was evaluated for quality and Meta analysis,and RevMan 5.3 software was used for statistical analysis.Results:A total of 11 randomized controlled trials were included,involving 480 cases in the case test group and 488 cases in the control group.Meta-analysis results showed that psychological intervention effectively improves the compliance of patients with chronic obstructive pulmonary disease in using non-invasive positive pressure ventilation[OR=2.84,95%CI(2.17,3.72),P<0.00001];the effect of increasing PaO 2 in the psychological intervention group was better than that of the conventional nursing group[MD=4.09,95%CI(3.98,4.19),P<0.00001];the effect of reducing PaCO_(2) was better than that of the conventional nursing group[MD=-8.17,95%CI(-12.32,-4.02),P=0.0001].Conclusion:Current evidence shows that psychological intervention can effectively improve the compliance of COPD patients with non-invasive positive pressure ventilation and improve the blood oxygen index.Choosing appropriate psychological intervention measures is an important factor to improve the compliance of non-invasive positive pressure ventilation.