早期康复运动对ICU机械通气患者谵妄影响的meta分析

Effect of early rehabilitation exercise on delirium in ICU patients undergoing mechanical ventilation:a meta-analysis

目的求证早期康复运动对重症监护病房(ICU)机械通气患者谵妄的影响。方法计算机检索中国生物医学文献服务系统(CBM)、万方数据库(Wanfang Data)、中国知网(CNKI)、维普数据库(VIP databases)、Cochrane Library、EMbase、PubMed、Web of science关于早期康复运动应用于ICU机械通气患者改善谵妄的随机对照试验,检索时限为建库至2022年4月30日,2名研究者独立筛选文献、提取资料及文献质量评价后,应用RevMan5.3统计软件进行meta分析。结果纳入14篇文献,涉及1766例患者。合并分析结果显示,试验组谵妄发生率、谵妄持续时间、机械通气时间及住院时间均低于对照组,差异均有统计学意义(P<0.05)。结论ICU实施早期康复运动确能降低机械通气患者谵妄发生率,缩短谵妄持续时间、机械通气时间及住院时间,建议临床完善优化方案后推广使用。

Objective To verify the effect of early rehabilitation exercise on delirium in patients with mechanical ventilation in intensive care unit(ICU).Methods Randomized controlled trials of early rehabilitation exercise in improving delirium in ICU patients with mechanical ventilation were obtained by searching the China Biomedical Literature Database(CBM),Wanfang Data,China National Knowledge Infrastructure,VIP databases,Cochrane Library,EMbase,PubMed and Web of Science from the establishment of the database to April 30,2022.After two researchers independently screened the literature,extracted the data and evaluated the quality of the literature,meta-analysis was carried out by RevMan 5.3 software.Results A total of 14 literatures involving 1766 patients were included.The combined analysis showed that the incidence of delirium,duration of delirium,mechanical ventilation time and length of hospital stay in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion Early rehabilitation exercise in ICU can reduce the incidence of delirium in mechanically ventilated patients,shorten the duration of delirium,mechanical ventilation time and length of hospital stay.It is recommended to promote the use in clinical ICU after improving the program.