出院计划应用于脑卒中病人干预效果的Meta分析

Intervention effect of discharge plan applied to stroke patients:a Meta-analysis

目的:通过Meta分析对出院计划应用于脑卒中病人的干预效果进行评价。方法:对中国知网、万方数据库、维普数据库、中国生物医学文献数据库(CBM)、the Cochrane Library、EMbase、PubMed、Web of Science自建库至2022年1月31日的所有随机对照试验进行检索。由2名研究者严格按照纳入、排除标准分别独立进行文献筛选和数据提取。运用RevMan 5.3软件对所纳入文献进行Meta分析。结果:最终纳入16篇文献。Meta分析结果显示,出院计划在促进神经功能恢复[MD=-3.95,95%CI(-4.80,-3.09),P<0.00001]、减少病人再入院率[OR=0.23,95%CI(0.10,0.56),P<0.001]及提高病人自我效能[MD=3.74,95%CI(3.19,4.28),P<0.01]、生活质量[MD=3.29,95%CI(1.91,4.66),P<0.01]和自理能力[MD=13.45,95%CI(4.86,22.04),P=0.002]方面优于对照组。结论:当前证据表明,出院计划可以改善脑卒中病人神经损伤程度、降低再入院率及提高病人日常生活活动能力、自我效能和生活质量。

Objective:To systematically evaluate the intervention effect of discharge plan applied to stroke patients.Methods:All randomized controlled trials were searched from CNKI,WanFang Database,VIP,CBM,the Cochrane Library,EMbase,PubMed,Web of Science from inception to January 31,2022.Two researchers strictly followed inclusion and exclusion criteria and independently carried out literature screening and data extraction.RevMan 5.3 software was used for Meta-analysis.Results:Finally,16 studies were included.Meta-analysis results showed that the discharge plan group was better than the control group in terms of promoting neurological recovery[MD=-3.95,95%CI(-4.80,-3.09),P<0.00001],reducing the rate of patient readmission[OR=0.23,95%CI(0.10,0.56),P<0.001],improving self-efficacy[MD=3.74,95%CI(3.19,4.28),P<0.01],quality of life[MD=3.29,95%CI(1.91,4.66),P<0.01],and self-care ability[MD=13.45,95%CI(4.86,22.04),P=0.002].Conclusions:Current evidence shows that the discharge plan can improve the nerve damage of stroke patients,reduce the rate of readmission,and improve the ability of daily living activities,self-efficacy and quality of life.