新生儿重症监护病房实施家庭参与式照护模式安全性的Meta分析

Safety of family integrated care model in neonatal intensive care unit:a Meta-analysis

目的评价新生儿重症监护病房实施家庭参与式照护(family integrated care,FICare)模式的安全性。方法检索PubMed、Embase、Cochrane Library、CINAHL、中国知网、万方数据库和中华医学期刊全文数据库关于新生儿FICare的临床研究,检索时间为2010年1月1日至2022年5月28日。根据纳入研究类型的不同采用Cochrane系统评价手册中的偏倚风险评估工具2及队列评价标准进行文献质量评价。应用Review Manager 5.3软件进行Meta分析。结果共纳入6篇随机对照试验和4篇队列研究。Meta分析结果显示,与传统无陪护照护模式相比,FICare不增加医院感染(RR=0.75,95%CI 0.46~1.24,P=0.27)及病情不稳定(RR=0.86,95%CI 0.61~1.22,P=0.40)的发生风险;FICare组全因死亡率虽高于对照组(RR=2.74,95%CI 0.88~8.57,P=0.08),但差异无统计学意义。结论FICare与传统无陪护照护模式相比,不增加医院感染、病情不稳定及不良事件发生的风险,在新生儿重症监护病房实施FICare是安全可行的。

Objective To systematically evaluate the safety of family integrated care(FICare)model in neonatal intensive care unit(NICU).MethodsMultiple medical databases were searched for clinical studies on FICare in NICU published from January 1,2010 to May 28,2022.The quality of the literature was evaluated using Risk of Bias 2 tool and cohort evaluation criteria from the Cochrane Systematic Evaluation Manual depending on the types of studies included.Meta-analysis was performed using Review Manager 5.3 software.ResultsSix randomized controlled trials and four cohort studies were included for meta-analysis.The results of meta-analysis showed that compared with the traditional care model,FICare model did not increase the risk of nosocomial infection(RR=0.75,95%CI 0.46-1.24,P=0.27)and unstable medical conditions(RR=0.86,95%CI 0.61-1.22,P=0.40).No significant difference existed in the all-cause mortality between FICare and traditional care(RR=2.74,95%CI 0.88-8.57,P=0.08).ConclusionsFICare does not increase the risk of nosocomial infection,unstable medical conditions and adverse events compared with traditional care.It is safe and feasible to implement FICare in NICU.