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集束化护理干预对脑卒中患者压疮的影响:一项Meta分析。

Effects of bundle-care interventions on pressure ulcers in patients with stroke: A meta-analysis.

作者信息

Wang Li-Ping, Gao Ming-Ming, Wang Xiu-Qin, Gu Min-Min, Qi Qin-De

机构信息

Department of Neurology, Jinan City People's Hospital, Jinan, China.

Department of Cadre Healthcare, Jinan City People's Hospital, Jinan, China.

出版信息

Int Wound J. 2023 Oct 18;21(2). doi: 10.1111/iwj.14432.

Abstract

We conducted a meta-analysis to assess the effects of bundle-care interventions on pressure ulcers in patients with stroke to provide a basis for clinical work. Randomised controlled trials on the effects of bundle-care interventions in patients with stroke were identified using computerised searches of the PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, VIP and Wanfang databases, from the time of inception of each database to July 2023, supplemented by manual literature searches. Two researchers independently retrieved and screened the articles, extracted the data and evaluated the quality of the included studies. After reaching consensus, meta-analysis was performed using RevMan 5.4. Twenty-four papers were included, involving 3330 patients of whom 1679 were in the intervention group and 1651 were in the control group. The results showed that, compared with standard care, bundle-care interventions significantly reduced the incidence of pressure ulcers (3.28% vs. 14.84%, odds ratio [OR]: 0.19, 95% confidence interval [CI]: 0.14-0.26, p < 0.001), and aspiration (5.60% vs. 18.84%, OR: 0.25, 95% CI: 0.17-0.39, p < 0.001), and improved patient satisfaction with nursing care (96.59% vs. 84.43%, OR. 5.45, 95% CI: 3.76-7.90, p < 0.001). Current evidence suggests that care bundles are significantly better than conventional nursing measures in preventing pressure ulcers and aspiration, and improving patient satisfaction with nursing care in patients with stroke, and are worthy of clinical promotion and application.

摘要

我们进行了一项荟萃分析,以评估集束护理干预措施对中风患者压疮的影响,为临床工作提供依据。通过对PubMed、Embase、Cochrane图书馆、中国知网、维普和万方数据库进行计算机检索,从各数据库建库至2023年7月,查找关于集束护理干预措施对中风患者影响的随机对照试验,并辅以手工文献检索。两名研究人员独立检索和筛选文章,提取数据并评估纳入研究的质量。达成共识后,使用RevMan 5.4进行荟萃分析。共纳入24篇论文,涉及3330例患者,其中干预组1679例,对照组1651例。结果显示,与标准护理相比,集束护理干预措施显著降低了压疮发生率(3.28%对14.84%,比值比[OR]:0.19,95%置信区间[CI]:0.14 - 0.26,p < 0.001)、误吸发生率(5.60%对18.84%,OR:0.25,95% CI:0.17 - 0.39,p < 0.001),并提高了患者对护理的满意度(96.59%对84.43%,OR:5.45,95% CI:3.76 - 7.90,p < 0.001)。目前的证据表明,在预防中风患者的压疮和误吸以及提高患者对护理的满意度方面,集束护理明显优于传统护理措施,值得临床推广应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3844/10828713/a5d2e663bf78/IWJ-21-e14432-g006.jpg

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