主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
《中文核心期刊要目总览》核心期刊

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机械通气患者早期主动活动效果的Meta分析

杨丽平 张志刚 张彩云 马晓佳 田金徽 张永红 岳伟岗 汪袁云子   

  1. 兰州大学第一医院重症医学科,730000 兰州市(杨丽平,张志刚,岳伟岗);护理部(张彩云);心内科(张永红);普外二科(汪袁云子);中国科学院文献情报中心(马晓佳);兰州大学循证医学中心(田金徽)
  • 出版日期:2017-06-25 发布日期:2017-06-25
  • 基金资助:
    甘肃省卫生行业科研计划项目(GSWSKY-2015-86)

The effect of early active mobilization for patients with mechanical ventilation in Intensive Care Unit: a Meta analysis

  • Online:2017-06-25 Published:2017-06-25

摘要: 目的:评价早期主动活动在ICU机械通气患者中的应用效果。方法:计算机检索Cochrane Library、Pubmed、Web of Science、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)和万方数据库中有关机械通气患者早期活动的随机对照试验(RCT),并辅助其他检索。2名研究者独立根据Cochrane系统评价方法对纳入文献进行质量评价和资料提取,采用Stata/SE 12.0软件进行Meta分析。结果:共纳入11篇RCT,718名患者,Meta分析结果显示:机械通气时间SMD=-0.77,95%CI(-1.30~-0.24);ICU住院时间SMD=-0.50,95%CI(-0.96~-0.04);呼吸机相关性肺炎(VAP)OR=0.13,95%CI(0.03~0.62);ICU获得性衰弱(ICU-AW)SMD=0.36,95%CI(0.02~0.71),合并效应有统计学意义;病死率OR=0.89,95%CI(0.51~1.55),虽倾向有利结局,但无统计学意义。结论:ICU机械通气患者进行早期主动活动安全有效,不但能缩短机械通气和ICU住院时间,并能降低VAP和ICU-AW的发生率,值得临床推广应用。

Abstract: Objective: To evaluate the effectiveness and safety of early active mobilization in patients with mechanical ventilation in Intensive Care Unit. Methods: The following databases such as Cochrane Library, PubMed, Web of Science, CNKI, CBM and WanFang Data electronically for Randomized Controlled Trials (RCT) were searched, and other sources as supplement was also retrieved. The quality evaluation and data extraction were carried out by two reviewers, and the Stata/SE 12.0 software was used for Meta analysis. Results: Totally 11 RCTs, 718 patients were enrolled. The results of Meta-analysis showed that the SMD of duration of mechanical ventilation was -0.77 with 95% CI (-1.30, -0.24) and the SMD of the length of stay in ICU was -0.50 with 95% CI (-0.96, -0.04) and the OR of the incidence of Ventilator Associated Pneumonia (VAP) was 0.13 with 95% CI (0.03, 0.62) and the SMD of the incidence of Intensive Care Unit Acquired Weakness (ICU-AW) was 0.36 with 95% CI (0.02, 0.71). The combined effect was statistically significant. The OR of the mortality was 0.89 with 95% CI (0.51~1.55) and not statistically significant. Conclusion: Early active mobilization is effective and safe for patients with mechanical ventilation. It can not only reduce the time of mechanical ventilation and ICU stay, but also can reduce the incidence of VAP and ICU-AW, and thus is worthy of clinical application.