ICU转出患者睡眠障碍发生率的系统评价

Prevalence of sleep disorders in post-ICU patients:a systematic review

目的系统评价ICU转出患者睡眠障碍的发生率,为早期预防ICU转出患者发生睡眠障碍提供理论依据。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、CINAHL、中国生物医学文献数据库、中国知网、万方数据库和维普数据库,检索时限为建库至2022年6月,由2名研究者独立根据纳入和排除标准筛选文献,采用纽尔卡斯-渥太华量表(Newcastle-Ottawa Quality Scale,NOS)对纳入文献进行质量评价,采用Stata SE.12软件进行数据分析。结果共纳入28篇文献,共3170例患者。ICU转出患者主观睡眠障碍总体发生率为51.84%[95%CI(45.17%~58.51%)]。亚组分析结果显示,ICU转出1个月内、1~3个月、>3~6个月和>6个月,主观睡眠障碍发生率分别为50.51%[95%CI(40.97%~60.05%)]、53.34%[95%CI(44.86%~61.82%)]、49.44%[95%CI(32.71%~66.16%)]、29.55%[95%CI(13.28%~45.82%)]。单个协变量Meta回归分析结果显示,样本量、国家与该研究的异质性有关(P<0.05)。结=论ICU转出患者睡眠障碍发生率较高,护理人员应尽早采取相关预防措施,加强对患者睡眠教育的指导,降低睡眠障碍发生率。

Objective To systematically evaluate the prevalence of sleep disorders and provide evidence for early prevention of sleep disorders in post-ICU patients.Methods PubMed,Embase,Web of Science,the Cochrane Library,CINAHL,CBM,CNKI,WanFang Data and VIP were searched from inception to June 2022.There were 2 researchers who independently screened the literature and assessed the quality of included studies using Critical Appraisal Tools published by Newcastle-Ottawa Quality Scale(NOS).The meta-analysis was performed by StataSE.12 software.Results A total of 28 studies were included in this study with a total of 3170 patients.The prevalence of subjective sleep disorders by random effects model was 51.84%[95%CI(45.17%~58.51%)].The results of subgroup analysis showed that the prevalence of subjective sleep disorders within 1 month,1~3 months,>3~6 months and>6 months after ICU discharge was 50.51%[95%CI(40.97%~60.05%)]、53.34%[95%CI(44.86%~61.82%)]、49.44%[95%CI(32.71%~66.16%)]、29.55%[95%CI(13.28%~45.82%)],respectively.Meta regression results of single covariate showed that sample size and country were related to heterogeneity(P<0.05).Conclusion The prevalence of sleep disorders in post-ICU patients is high.Nursing staff should take relevant interventions,strengthen sleep health education and guidance for patients,and reduce the incidence.