摘要
目的系统评价临床护理路径(CNP)在股骨颈骨折患者中的应用效果。方法计算机检索PubMed、The Cochrane Library(2014年第9期)、CNKI、VIP和WanFang Data数据库,搜集CNP应用于股骨颈骨折的相关随机对照试验(RCT),检索时限均为建库至2014年9月。由两位研究者独立筛选文献、提取资料,并评价纳入研究的偏倚风险后,采用RevMan 5.1软件进行Meta分析。结果共纳入24个RCT,包括1 852例患者。Meta分析结果显示:与对照组相比,CNP组患者住院天数更少[MD=–4.47,95%CI(–5.32,–3.62),P<0.000 01],满意度更高[OR=5.52,95%CI(3.75,8.14),P<0.000 01],知识达标率更高[OR=5.97,95%CI(3.57,9.96),P<0.000 01],并发症发生率更低[OR=0.34,95%CI(0.24,0.48),P<0.000 01]。结论 CNP能缩短患者住院天数,提高患者的满意度和知识达标率,并减少并发症发生率。受纳入研究数量和质量所限,上述结论尚需开展更多高质量研究予以验证。
Objective To systematically review the effetcs of clinical nursing pathway （CNP） in patients with femoral neck fracture. Methods Databases including PubMed, The Cochrane Library （Issue 9, 2014）, CNKI, VIP and WanFang Data were electronically searched to collect randomized controlled trials （RCTs） about CNP in management of patients with femoral neck fracture from inception to September 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results A total of 24 RCTs involving 1 852 patients were included. The results of meta-analysis showed that： compared with the control group, the time of hospitalization was decreased （MD= -4.47, 95%CI -5.32 to -3.62, P〈0.000 01）, the patients＇ nursing satisfaction was increased （OR=5.52, 95%CI 3.75 to 8.14, P〈0.000 01）, the achievement rate of knowledge was increased （OR=5.97, 95%CI 3.57 to 9.96, P〈0.000 01） and the incidence of postoperative complications was decreased （OR=0.34, 95%CI 0.24 to 0.48, P〈0.000 01） in the CNP group. Conclusion CNP can reduce the time of hospitalization, improve patients＇ nursing satisfaction, improve the achievement rate of knowledge, as well as reduce the incidence of postoperative complications. Due to limited quality and quantity of the included studies, the above conclusion need more high quality studies to verify.
出处
《中国循证医学杂志》
CSCD
2015年第11期1327-1333,共7页
Chinese Journal of Evidence-based Medicine
关键词
股骨颈骨折
临床护理路径
系统评价
META分析
随机对照试验
Femoral neck fracture
Clinical nursing pathway
Systematic review
Meta-analysis
Randomizedcontrolled trial
