Provençal Sarah-Claude, Bond Suzie, Rizkallah Elie, El-Baalbaki Ghassan
Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada.
Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
Burns. 2018 Dec;44(8):1870-1881. doi: 10.1016/j.burns.2018.04.017. Epub 2018 May 24.
Evidence from clinical trials suggests psychological interventions should be considered as an adjunct to medications.
The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of clinical hypnosis on pain, anxiety and medication needs during wound care in adults suffering from a burn injury.
Medline, PsychINFO, CINAHL, Embase, ISI, SCOPUS, Cochrane, and Proquest databases were searched for randomized controlled trials comparing hypnosis to other interventions during dressing change in adult patients.
Two independent reviewers extracted relevant articles and assessed their methodological quality. Only six studies met the inclusion criteria and were described in detail. Available data was pooled with Revman 5.3.
For the primary outcome, we found a statistically significant difference in pain intensity ratings favoring hypnosis (MD=-8.90, 95% CI -16.28, -1.52). For the secondary outcomes, there was a statistically significant difference in anxiety ratings favoring hypnosis (MD=-21.78, 95% CI -35.64, -7.93) and no difference in medication usage (MD=-0.07, 95% CI -0.32, 0.17).
These results suggest that hypnosis reduces pain intensity and anxiety ratings in adults undergoing burn wound care. However, because of the limitations discussed, clinical recommendations are still premature.
临床试验证据表明，心理干预应被视为药物治疗的辅助手段。
本系统评价和荟萃分析的目的是评估临床催眠对成年烧伤患者伤口护理期间疼痛、焦虑及药物需求的有效性。
检索了Medline、PsychINFO、CINAHL、Embase、ISI、SCOPUS、Cochrane和Proquest数据库，以查找比较成年患者换药期间催眠与其他干预措施的随机对照试验。
两名独立评审员提取相关文章并评估其方法学质量。仅六项研究符合纳入标准并进行了详细描述。可用数据用Revman 5.3进行汇总。
对于主要结局，我们发现疼痛强度评分在统计学上有显著差异，支持催眠（MD=-8.90，95%CI -16.28，-1.52）。对于次要结局，焦虑评分在统计学上有显著差异，支持催眠（MD=-21.78，95%CI -35.64，-7.93），而药物使用无差异（MD=-0.07，95%CI -0.32，0.17）。
这些结果表明，催眠可降低成年烧伤伤口护理患者的疼痛强度和焦虑评分。然而，由于所讨论的局限性，目前提出临床建议仍为时过早。
