临床护理路径对老年人髋关节置换术后影响的Meta分析

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摘要目的系统评价临床护理路径对老年人髋关节置换术后的影响。方法计算机检索PubMed、EMBase、The Cochrane Library(2018年5期)、CBM、CNKI、VIP和Wan Fang Data。搜集临床护理路径对老年人髋关节置换术后影响的随机对照试验,检索自建库截至2018-05-31。由2位研究人员独立进行文献筛选、数据提取和质量评价后,采用RevMan5.3软件进行Meta分析。结果共纳入10个随机对照试验,包括917例患者。Meta分析结果显示:与常规护理和康复训练相比,临床护理路径可显著提高患者的满意度[RR=1.18,95%CI(1.11,1.26),P＜0.01]、降低并发症发生率[RR=0.21,95%CI(0.12,0.36),P＜0.01]、缩短住院时间[RR=-3.68,95%CI(-5.30,-2.07),P＜0.01],且差异均具有统计学意义。结论临床护理路径可以提高老年人髋关节置换术后患者的满意度,缩短住院天数,并降低并发症发生率。

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关键词 ：临床护理路径, 髋关节置换术, 随机对照试验, 系统评价

Abstract：Objective To systematically evaluate the effectiveness of clinical nursing pathway for hip replacement in elderly patients.Methods Databases including PubMed, EMBase, the Cochrane Library (Issue 5, 2018), CBM, CNKI, VIP and Wan Fang Database were searched to collect randomized controlled trials (RCTs) about the effectiveness of clinical nursing pathway for hip replacement in elderly patients from inception to May 2018. Two reviewers independently screened related literature, extracted data and assessed the quality of included studies. Then, meta-analysis was conducted with RevMan5.3 software.Results A total of 10 studies involving 917 patients were included. The Results of meta-analysis showed that compared with the routine nursing and rehabilitation training, the clinical nursing pathway could significantly improve the patients’level of satisfaction [RR=1.18,95%CI(1.11,1.26),P＜0.01], reduce the incidence of complications [RR=0.21,95%CI(0.12,0.36),P＜0.01], and shorten the time of hospitalization [RR=-3.68,95%CI(-5.30,-2.07),P＜0.01], and the difference was statistically significant.Conclusions Current evidence shows that the clinical nursing pathway can improve the satisfaction of elderly patients after hip replacement, shorten the length of hospital stay, and reduce the incidence of complications.

Key words： clinical nursing pathway hip replacement randomized controlled trial systematic review

收稿日期: 2018-07-10

ZTFLH:

R473

作者简介: 唐鸣,本科学历,主管护师。

引用本文:

唐鸣, 李菁, 沈颖丽, 符秀娟, 李逸冰. 临床护理路径对老年人髋关节置换术后影响的Meta分析[J]. 武警医学, 2018, 29(11): 1024-1027. TANG Ming, LI Jing, SHEN Yingli, FU Xiujuan, LI Yibing. Meta-analysis of effect of clinical nursing pathway on hip replacement in elderly patients. Med. J. Chin. Peop. Armed Poli. Forc., 2018, 29(11): 1024-1027.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2018/V29/I11/1024

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