循证护理对ICU成人患者压疮预防效果的Meta分析

Meta-analysis of the prevention effect of evidence-based nursing on pressure ulcers in ICU adult patients

目的通过Meta分析系统分析循证护理在ICU成人患者压疮预防中的应用效果。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、中国生物医学文献数据库、维普数据库、万方数据库中有关循证护理对ICU成人患者压疮预防效果的随机对照研究,根据干预方法分为循证护理组和常规护理组。检索时间为自建库以来至2020年12月,由2名研究员独立进行文献的筛选和数据的提取,采用Cochrane协作网的RCT偏倚风险评价工具进行文献质量评价,RevMan 5.3软件进行Meta分析。结果共纳入11篇文献,1395名ICU患者,循证护理组ICU成人患者的压疮发生率低于常规护理组[OR=0.24,95%CI(0.16,0.37),P<0.00001];将循证护理用于ICU成人患者可以缩短压疮形成时间[SMD=1.69,95%CI(1.41,1.97),P<0.00001],提升患者对护理的满意度[OR=0.24,95%CI(0.16,0.37),P<0.00001]。结论循证护理对于ICU成人患者压疮的预防效果要比常规护理更显著,但由于本研究只检索到了符合纳排标准的中文文献,结论还需要有更高质量的研究来进一步证实。

Objective To analyze the effect of evidence-based nursing in the prevention of pressure ulcers in adult patients in ICU through Meta analysis system.Methods Randomized controlled studies of evidence-based care in the prevention of pressure ulcers in ICU adult patients were searched in PubMed,Embase,Cochrane Library,Web of Science,CNKI,China Biomedical Literature Database,Weipu Database,and Wanfang Database.According to the intervention methods,the data were divided into evidence-based nursing group and routine nursing group.The search time was from the establishment of the database to December 2020.Two researchers independently screened the literature and extracted data.The RCT bias risk assessment tool of the Cochrane Collaboration was used to evaluate the quality of the literature,and the RevMan 5.3 software was used for Meta-analysis.Results A total of 11 articles were included,including 1395 ICU patients.The incidence of pressure ulcers in adult ICU patients in the evidence-based care group was lower than that in the conventional care group[OR=0.24,95%CI(0.16,0.37),P<0.00001].Applying evidence-based care to adult patients in ICU could shorten the time of pressure ulcer formation[SMD=1.69,95%CI(1.41,1.97),P<0.00001],and improve patient satisfaction with care[OR=0.24,95%CI(0.16,0.37),P<0.00001].Conclusion Evidence-based care is more effective in preventing pressure ulcers in ICU adult patients than conventional care.However,since this study only retrieved Chinese literature that meets the criteria for inclusion and exclusion,the conclusion needs to be further confirmed by higher-quality studies.