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心理干预能否减轻血液透析患者的抑郁症状？：一项遵循PRISMA的随机对照试验的荟萃分析。

Do psychological interventions reduce depression in hemodialysis patients?: A meta-analysis of randomized controlled trials following PRISMA.

作者信息

Xing Lu, Chen Ruiqi, Diao Yongshu, Qian Jiahui, You Chao, Jiang Xiaolian

机构信息

West China School of Nursing Department of Neurosurgery Department of Nephrology, West China Hospital West China School of Public Health, Sichuan University, Chengdu, Sichuan, China.

出版信息

Medicine (Baltimore). 2016 Aug;95(34):e4675. doi: 10.1097/MD.0000000000004675.

DOI:10.1097/MD.0000000000004675
PMID:27559971
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5400338/
Abstract

BACKGROUND

Depression is highly prevalent in hemodialysis patients and results in poor patient outcomes. Although psychological interventions are being developed and used for these patients, there is uncertainty regarding the effectiveness of these interventions. The purpose of this meta-analysis is to evaluate the effects of psychological interventions on depression treatment in hemodialysis patients.

METHODS

All randomized controlled trials (RCTs) relevant to the depression treatment of hemodialysis patients through psychological interventions were retrieved from the following databases: Embase, Pubmed, PsycINFO, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. The reference lists of identified RCTs were also screened. The Cochrane risk of bias tool was used to evaluate the quality of the studies, RevMan (5.3) was used to analyze the data, and the evidence quality of the combined results was evaluated using GRADE (3.6.1).

RESULTS

Eight RCTs were included. The combined results showed that psychological interventions significantly reduced the scores of the Beck Depression Inventory (P<0.001) and interdialysis weight gain (P<0.001). However, due to the high heterogeneity, effect size combinations of sleep quality and quality of life were not performed.

CONCLUSION

Psychological interventions may reduce the degree of depression and improve fluid intake restriction adherence. More rigorously designed research is needed.

摘要

背景

抑郁症在血液透析患者中高度流行，并导致患者预后不良。尽管正在为这些患者开发和使用心理干预措施，但这些干预措施的有效性仍存在不确定性。本荟萃分析的目的是评估心理干预对血液透析患者抑郁症治疗的效果。

方法

通过心理干预对血液透析患者抑郁症治疗的所有随机对照试验（RCT）从以下数据库中检索：Embase、Pubmed、PsycINFO、Cochrane系统评价数据库和Cochrane对照试验中央注册库。还对已识别RCT的参考文献列表进行了筛选。使用Cochrane偏倚风险工具评估研究质量，使用RevMan（5.3）分析数据，并使用GRADE（3.6.1）评估合并结果的证据质量。

结果

纳入八项随机对照试验。合并结果显示，心理干预显著降低了贝克抑郁量表评分（P<0.001）和透析间期体重增加（P<0.001）。然而，由于异质性较高，未对睡眠质量和生活质量的效应量组合进行分析。

结论

心理干预可能会降低抑郁程度并提高液体摄入限制的依从性。需要更严格设计的研究。

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