Department of Cardiovascular Medicine, Ganzhou City People's Hospital, Ganzhou, China.
Department of Information Centre, Ganzhou City People's Hospital, Ganzhou, China.
Int Wound J. 2024 Mar;21(3):e14494. doi: 10.1111/iwj.14494. Epub 2023 Nov 20.
Pressure ulcers (PUs) are a common complication in postoperative patients with traumatic brain injury, and this study used a meta-analysis to assess the effects of comprehensive nursing applied in PUs intervention in postoperative patients with traumatic brain injury. A computerised systematic search of the PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature Database (CBM), VIP and Wanfang databases was performed to collect publicly available articles on randomised controlled trials (RCTs) on the effects of comprehensive nursing interventions in postoperative patients with traumatic brain injury published up to August 2023. Two researchers independently completed the search and screening of the literature, extraction of data and quality assessment of the included literature based on the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.4 software. Twenty-eight articles were finally included, for a cumulative count of 2641 patients, of which 1324 were in the intervention group and 1317 in the control group. The results of the meta-analysis showed that, compared with conventional nursing, comprehensive nursing intervention helped to reduce the incidence of PUs in postoperative patients with traumatic brain injury (5.14% vs. 19.67%, odds ratio [OR]: 0.22, 95% confidence interval [CI]: 0.16-0.29, p < 0.00001) and reduced the incidence of postoperative complications (7.87% vs. 25.84%, OR: 0.22, 95% CI: 0.11-0.43, p < 0.0001), while increasing patient satisfaction (96.67% vs. 75.33%, OR: 9.5, 95% CI: 3.63-24.88, p < 0.00001). This study concludes that a comprehensive nursing intervention applied to postoperative patients with traumatic brain injury can significantly reduce the incidence of PUs and postoperative complications as well as improve nursing satisfaction, and it is recommended for clinical promotion. However, due to the limitations of the studies' number and quality, more high-quality, large-sample RCTs are needed to further validate the conclusions of this study.
压力性溃疡(PU)是创伤性脑损伤术后患者的常见并发症,本研究采用荟萃分析评估综合护理在创伤性脑损伤术后患者 PU 干预中的效果。计算机检索 PubMed、EMBASE、Cochrane 图书馆、中国知网、中国生物医学文献数据库(CBM)、维普及万方数据库,收集公开发表的关于综合护理干预对创伤性脑损伤术后患者影响的随机对照试验(RCT),检索时限均从建库至 2023 年 8 月。由 2 位研究者根据纳入和排除标准独立筛选文献、提取资料并评价纳入研究的质量后,采用 RevMan 5.4 软件进行荟萃分析。最终纳入 28 篇文献,累计 2641 例患者,其中干预组 1324 例,对照组 1317 例。荟萃分析结果显示,与常规护理相比,综合护理干预可降低创伤性脑损伤术后患者 PU 的发生率[5.14%比 19.67%,比值比(OR):0.22,95%置信区间(CI):0.16-0.29,P<0.00001]和术后并发症的发生率[7.87%比 25.84%,OR:0.22,95%CI:0.11-0.43,P<0.0001],提高患者满意度[96.67%比 75.33%,OR:9.5,95%CI:3.63-24.88,P<0.00001]。本研究认为,综合护理干预应用于创伤性脑损伤术后患者可显著降低 PU 及术后并发症的发生率,提高护理满意度,建议临床推广应用。但受研究数量和质量的限制,仍需要更多高质量、大样本的 RCT 进一步验证本研究的结论。