临床护理路径在慢性阻塞性肺疾病患者应用效果的Meta分析

目的 采用Meta分析,系统评价临床护理路径在慢性阻塞性肺疾病患者中的应用效果.方法计算机检索PubMed、Embase、The Cochrane Library(2015年第12期)、CNKI、VIP和wanfangdata数据库,全面查找临床护理路径在慢性阻塞性肺疾病患者应用效果的随机对照实验(RCT),检索时间均为从建库至2015年12月.由2名评价员按照纳入与排除标准独立筛选文献、提取资料并评价质量后,采用RevMan 5.3软件进行Meta分析.结果最终纳入49个RCT,包括12311例患者.Meta分析结果显示,与常规护理相比,临床护理路径干预可提高疾病相关知识的掌握〔OR=5.56,95％CI(3.14,9.86),P<0.00001〕、健康教育满意度〔OR=6.62,95％CI(4.11,10.64),P<0.00001〕、治疗的总有效率〔OR=4.75,95％CI(3.07,7.43),P=0.96〕,并可提高患者对护理的满意度、遵医行为,减少住院时间及降低住院费用,差异均有统计学意义(均P<0.05).结论临床护理路径对慢性阻塞性肺疾病患者的实施效果均优于传统护理模式.然而,由于文献存在偏倚的风险较高,分析结果仍需要更多的临床护理实践及大量质量较高的文献来支持.

Meta analysis of clinical nursing pathway on patients ' application effect of chronic obstructive pulmonary disease

Objective To systematically evaluate the Meta analysis of clinical nursing pathway on patients' ap-plication effect of chronic obstructive pulmonary disease. Methods Computer was used to retrieve the database of PubMed, EMbase, The Cochrane Library (phase 12, 2015), CNKI, VIP and wangfangdata, so as to comprehensively search randomized controlled trials ( RCT) for the application effect of clinical nursing pathway on the patients of chronic obstructive pulmonary disease. The retrieval time limit was from the time of database to December, 2015. RevMan 5. 3 software was used to have Meta analysis after 2 evaluators independently filtered literature, extracted data and evaluated the quality according to the collection and exclusion criteria. Results Finally, 49 RCTs were collected, including 12311 patients. Meta analysis result showed that clinical nursing pathway intervention could improve the mastery of disease related knowledge 〔OR=5. 56 , 95％CI ( 3. 14 , 9. 86 ) , P<0. 00001〕, health education satisfaction 〔OR=6. 62 , 95％CI (4. 11, 10. 64), P<0. 00001〕 and total effective rate 〔OR=4. 75, 95％CI (3. 07, 7. 43), P=0. 96〕 of treatment compared with usual nursing. In addition, it could improve the satisfaction of patients with nursing, patients' behavior of following doctor ' s instruction, reduce hospital stays and reduce hospitalization expenses ( P<0. 05) . Conclusion The implementation effect of clinical nursing pathway on the patients of chronic obstructive pulmonary dis-ease is superior to traditional nursing mode. However, since this literature has high risk of bias, the analysis result still needs further clinical nursing practice and a large number of high-quality literatures to support.