延续护理对强直性脊柱炎病人生活质量及心理影响的Meta分析

目的]评价延续护理对强直性脊柱炎(AS)病人生活质量及心理的影响。方法]检索PubMed、the Cochrane Librany、EMbase、CBM、知网、万方、维普等中外数据库,收集延续护理对强直性脊柱炎病人生活质量及心理影响的随机对照试验(RCT)进行Meta分析。结果]最终纳入14篇RCT文献,包括1724例病人,Meta分析结果显示:与对照组相比,试验组实施≤3个月的延续护理,可提高强直性脊柱炎病人生活质量(SF-36)各维度得分,差异均有统计学意义(P<0.0001);而>3个月延续护理对强直性脊柱炎病人生命质量的影响存在争议。≤3个月、>3个月延续护理对强直性脊柱炎病人综合功能状况MD=-0.93,95%CI(-1.38,-0.48),P<0.0001;MD=-0.81,95%CI(-1.37,-0.25),P=0.005]、心理状况(焦虑及抑郁情绪)MD=-10.25,95%CI(-14.79,-5.717),P=0.00001;MD=-7.78,95%CI(-10.19,-5.38),P=0.00001]的干预效果差异均有统计学意义(P<0.001)。结论]现有证据表明,≤3个月的延续护理可提高强直性脊柱炎病人的生活质量,而>3个月延续护理对生活质量的影响仍待进一步研究;延续护理可明显改善强直性脊柱炎病人的综合功能及心理状况。

Effects of continuous care on quality of life and psychological status of patients with ankylosing spondylitis:a Meta-analysis

Objective:To evaluate the impacts of continuous care on the quality of life(QOL)and psychology of patients with ankylosing spondylitis(AS).Methods:Randomized controlled trials(RCTs)on effects of continuous care on quality of life and psychological status of patients with ankylosing spondylitis were retrieved from databases,including PubMed,the Cochrane Librany,EMbase,China Biology Medicine disc(CBMdisc),Chinese Knowledge Network(CNKI),WanFang Database,and VIP Chinese Science and Technology Journal Full-text Database.And Meta-analysis was carried out.Results:Fourteen RCTs were finally included,involving 1724 patients.The Meta-analysis results showed that compared with the control group,the continuous care within 3 months in the experimental group could improve the QOL of AS patients(SF-36).The scores in each dimension have significant differences(P<0.0001).There still exists controversy on effect of continuous care over 3 months on the QOL of AS patients.Intervention effects of continuous care within 3 months and over 3 months on the comprehensive functional status of AS patientsMD=-0.93,95%CI(-1.38,-0.48),P<0.0001;MD=-0.81,95%CI(-1.37,-0.25),P=0.005]and psychological condition(anxiety and depression)MD=-10.25,95%CI(-14.79,-5.71),P=0.00001;MD=-7.78,95%CI(-10.19,-5.38),P=0.00001]all had significant differences(P<0.001).Conclusions:Existing evidence showed that continuous care within 3 months could improve the QOL of AS patients.And effect of continuous care over 3 months on QOL needs to be further studied.Continuous care could significantly improve comprehensive function and psychological status of AS patients.