ICU患者创伤后应激障碍危险因素的Meta分析被引量：46

A meta-analysis of risk factors for PTSD in intensive care unit survivors

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摘要目的通过Meta分析明确ICU治疗后生存者创伤后应激障碍(posttraumatic stress disoroler,PTSD)的危险因素。方法检索中英文数据库及纳入文献的参考文献,由2名评价人员按照标准独立筛选文献、提取资料、评价文献质量。采用RevMan 5.3分析软件对资料进行Meta分析。结果从864篇文献中筛选29篇(样本量为5125例),纳入危险因素115个,仅女性、受教育水平、Clarlson共病指数、氢化可的松的使用、镇静剂的使用、精神疾病史的合并效应量具有统计学意义,OR/RR及95%CI分别为1.39(1.17,1.66);0.88(0.80,0.97);1.31(1.03,1.65);0.13(0.04,0.39);3.70(1.7,8.05);3.75(1.96,7.18),是ICU治疗后PTSD的预测因素。结论目前ICU治疗后PTSD危险因素的研究证据尚不足,且PTSD评价标准和随访时间差异较大,尚需更多设计严谨、评价标准和随访时间统一的原始研究。 Objective To conduct a recta-analysis of risk factors for posttraumatic stress disorder symptoms in intensive care unit survivors. Methods Electronic databases and references of included studies were searched. Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data,and assessed the quality of included studies. Meta-analysis was conducted using RevManS.3. Results Totally 29 studies were identified from 864 papers including 5125 cases. A total of 115 risk factors were involved,and female,Charlson Comorbidity index,usage of hydrocortisone,usage of depressant,history of psychiatric disease were identified as having cumulative effects on PTSD among ICU survivors[OR/RR and 95%CI were 1.39（1.17,1.66）,0.88 （0.80,0.97）,1.31 （1.03,1.65）,0.13（0.04,0.39）,3.70（1.7,8.05）,and 3.75（1.96,7.18）,respectively]. Conclusion Because of insufficient evidence on risk factors for PTSD and inconsistent evaluation methods of PTSD and different follow-up time, more strictly designed original studies are needed to provide supports for early clinical interventions.

作者王烁侯婉玲胡蓉芳黄丽

机构地区福建医科大学护理学院

出处《中华护理杂志》 CSCD 北大核心 2016年第8期915-922,共8页 Chinese Journal of Nursing

基金国家自然科学基金项目(8120500) 教育部人文社会科学研究一般项目(11YJC19008) 福建省杰出青年教师人才支持项目(JA12165S)

关键词重症监护应激障碍创伤后危险因素 META分析 Intensive Care Stress Disorders,Post-traumatic Risk Factors Meta-Analysis

分类号 R472.2 [医药卫生—急诊医学]

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