ICU气管插管病人使用电动牙刷对口腔卫生效果影响的网状Meta分析

Effect of electric toothbrush on oral hygiene of patients with tracheal intubation in ICU:a network Meta-analysis

目的:采用网状Meta分析的方法评价不同电动牙刷组合方法在重症加强护理病房(ICU)气管插管病人口腔卫生方面的效果。方法:计算机检索the Cochrane Library、PubMed、Web of Science、CINAHL、EMbase、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库和维普数据库,检索时间限定为从建库至2020年12月13日,筛选出ICU气管插管病人使用电动牙刷相关的研究,并进行文献质量评价,使用Stata 15.1软件对数据进行网状Meta分析。结果:共纳入20篇相关文献,涉及12种口腔护理方式。网状Meta分析结果显示电动牙刷较常规护理在提高ICU气管插管病人口腔卫生方面具有显著效果。排序概率图显示电动牙刷蘸取牙膏结合生理盐水冲洗、负压吸引效果最好,常规护理和纯净水冲洗的效果最不理想,其余电动牙刷组合方式的效果居中。结论:现有证据表明,12种口腔护理方式中,电动牙刷蘸取牙膏结合生理盐水冲洗、同步负压吸引的效果最好,可达到提高ICU气管插管病人口腔卫生的效果。

Objective:To evaluate the efficacy of different electric toothbrush combinations in oral hygiene of patients with tracheal intubation in intensive care unit(ICU)by using network Meta-analysis.Methods:Studies related to the use of electric toothbrushes in ICU patients with tracheal intubation were retrieved from the Cochrane Library,PubMed,Web of Science,CINAHL,EMbase,CBM,CNKI,WanFang Database and VIP.The retrieval time was limited to December 13,2020.The literature quality of these studies was evaluated.Stata 15.1 software was used to perform network Meta-analysis of the data.Results:A total of 20 articles were included,involving 12 kinds of oral care methods.The results of network Meta-analysis showed that compared with routine nursing,electric toothbrush had a significant effect on improving oral hygiene of patients with tracheall intubation in ICU.The sorting probability graph showed that the electric toothbrush dipped in toothpaste combined with physiological saline washing combined with negative pressure suction had the best effect,the effect of routine care and pure water washing was the least ideal,and the effect of other electric toothbrush combinations was in the middle.Conclusions:Current evidence shows that among the 12 oral care methods,the effect of electric toothbrush dipped in toothpaste combined with normal saline flushing combined with synchronous negative pressure suction is the best,which can improve the oral hygiene of patients with tracheal intubation in ICU.