非药物干预对心脏大血管手术患者术后谵妄影响的网状Meta分析
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女,硕士在读,学生

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2021年度华中科技大学同济医学院护理学院自主创新基金项目(2021-3-1)


Effects of non-pharmacological interventions on postoperative delirium in patients undergoing cardiovascular surgery:a network Metaanalysis
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    目的 综合评价非药物干预对心脏大血管手术患者术后谵妄的影响,为选择最佳干预措施提供参考。 方法 计算机检索中国生物医学文献服务系统、中国知网、万方数据库、维普数据库、PubMed、Web of Science、Cochrane Library、Embase和Scopus数据库,检索时限为建库至2022年3月,收集不同非药物干预对心脏大血管手术患者术后谵妄影响的随机对照研究。由2名研究者独立筛选文献、提取资料并进行文献质量评价,运用Stata 16.0软件进行网状Meta分析。 结果 共纳入16项研究,总样本量为2 011例。网状Meta分析结果显示,针对性心理干预(OR=10.15,P<0.05)对患者术后谵妄的防治效果最佳,其次分别为早期活动、音乐疗法、ABCDE集束化护理措施、目标性镇静镇痛结合早期活动(OR=3.48~5.42,均P<0.05)等。 结论 针对性心理干预和早期运动分别为最佳的多组分和单一非药物干预措施,多组分非药物干预相比单一干预措施对预防心脏大血管手术患者术后谵妄更有优势。未来可根据循证证据制订 策略精准的多组分非药物干预方案,以降低患者术后谵妄发生率。

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    Objective To comprehensively evaluate the effects of non-pharmacological interventions on postoperative delirium in patients undergoing cardiovascular surgery, and to provide reference for selecting the best intervention measures. Methods Chinese Biomedical Literature Service System, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP database, PubMed, Web of Science, Cochrane Library, Embase and Scopus were searched from the establishment of the database to March 2022.Randomised controlled studies of the effects of different non-pharmacological interventions on postoperative delirium in patients undergoing cardiovascular surgery were retrieved.Two researchers independently screened the literatures, extracted the data, and evaluated the literature quality.Stata 16.0 software was used for network meta-analysis. Results Sixteen studies were included, with a total sample size of 2 011.The results of network meta-analysis showed that targeted psychological intervention (OR=10.15,P<0.05) had the best effect on prevention and treatment of postoperative delirium, followed by early activity, music therapy, ABCDE bundle nursing measures, targeted sedation analgesia combined with early activity (OR=3.48-5.42,P<0.05 for all). Conclusion Targeted psychological intervention and early exercise are the best multi-component and single non-pharmacological intervention measures, respectively.Multicomponent non-pharmacological interventions have advantages over single interventions for the prevention of postoperative delirium in patients undergoing cardiovascular surgery.In the future, a multi-component non-pharmacological intervention program with precise strategy can be developed based on evidence-based evidence to reduce the incidence of postoperative delirium.

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张玉芬,汪晖,胡凯利,黄宛冰.非药物干预对心脏大血管手术患者术后谵妄影响的网状Meta分析[J].护理学杂志,2023,28(1):34-39

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  • 收稿日期:2022-07-15
  • 最后修改日期:2022-10-03
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  • 在线发布日期: 2023-12-29