不同护理干预方式预防人工髋关节置换术后深静脉血栓形成效果的网状Meta分析

Reticular Meta-analysis of the effect on different nursing interventions to preventing deep vein thrombosis after hip replacement

目的深静脉血栓形成(DVT)是威胁人类生活质量的重要因素。本荟萃研究旨在分析不同护理干预方式在预防人工髋关节置换术后DVT的效果。方法计算机全面检索了PubMed、Cochrane Library、Web of Science、EMbase、CINAHL、MEDLINE、中国知网、万方数据库、中国生物医学数据库中建库至2022年4月关于人工髋关节置换术后深静脉血栓的护理干预文献。根据纳排标准,由2名研究者独立进行文献筛选和质量评价,在资料提取后使用StataMP 16和Addis1.16.8软件再进行网状Meta分析。结果最终纳入15项随机对照试验,共2415例患者。网状Meta分析结果显示,与常规护理相比,标准深静脉血栓预防操作流程、焦点解决干预、系统化精细护理、踝泵运动、追踪干预、预见性护理在降低深静脉血栓发生率方面,差异有统计学意义(P<0.05);其余护理干预方式与常规护理相比,并无统计学意义(P>0.05)。排序概率图下面积排序结果显示:16种护理干预方法中,标准DVT预防操作流程是最佳预防方法的可能性最大,追踪干预次之,常规护理最小。结论标准深静脉血栓预防操作流程可能是预防深静脉血栓的最优护理方式,但其适用性还应进一步验证。

Objective Deep vein thrombosis(DVT)is an important factor threatening the quality of human life.This Meta-study aims to analyze the effect of different nursing intervention methods in the prevention of DVT after hip arthroplasty.Methods PubMed,Cochrane Library,Web of Science,EMbase,EMbase,CINAHL,MEDLINE,CNKI,Wanfang database were screened from the establish of China biomedical database to April 2022.According to the volume exclusion criteria,literature screening and quality evaluation were performed independently by 2 investigators,and then the mesh Meta-analysis was performed by using StataMP 16 and Addis1.16.8 software after data extraction.Results Finally included in 15 randomized controlled trials with a total of 2415 patients.Meta-analysis showed that standard DVT prevention procedures,focus resolution intervention,systematic fine nursing,ankle pump exercise,tracking intervention,and foresight care decreased the incidence of DVT(P<0.05);the rest was not statistically significant compared with usual care(P>0.05).The area sorting results under the ranking probability chart show that among the 16 nursing intervention methods,the standard DVT prevention operation process is the most likely to be the best prevention method,followed by tracking intervention,and routine nursing is the least.Conclusion It might be the best nursing method for DVT prevention,but its applicability should be further verified.