综合护理措施对无创呼吸机治疗COPD合并呼吸衰竭的Meta分析
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摘要
目的评价综合护理措施对无创呼吸机治疗COPD合并呼吸衰竭患者的影响。方法选择中文检索词"综合护理"且"呼吸衰竭",检索中国学术期刊全文数据库、维普中文科技期刊全文数据库、万方数据知识服务平台及中国生物医学文献数据库,收集相关文献,检索时间范围为建库以来至2018年9月。用Meta分析方法对研究结果进行数据合并,并评价分析结果稳定性和可靠性。采用RevMan5.3软件进行统计处理。结果共纳入5篇文献。Meta分析显示:整体来看,综合护理措施相对于一般护理措施可以提高无创呼吸机治疗COPD合并呼吸衰竭患者的氧分压[随机效应模型,WMD=10.59,95%CI (7.04,14.14),P<0.001]、氧饱和度[固定效应模型,WMD=7.28,95%CI(6.33,8.24),P<0.001]、pH值[随机效应模型,WMD=0.10,95%CI(0.05,0.15),P<0.001],降低二氧化碳分压[随机效应模型,WMD=-7.10,95%CI(-9.66,-6.20),P<0.001]。结论综合护理措施对无创呼吸机治疗COPD合并呼吸衰竭患者PaO_2、PaCO_2、SaO_2、pH值的改善有一定积极作用。
Objective To evaluate the effect of comprehensive nursing measures on patients with COPD and respiratory failure treated with noninvasive ventilator.Methods The Chinese search term "comprehensive nursing" and "respiratory failure" were selected. The Chinese academic journal full-text database, the Weipu Chinese scientific journal full-text database, the Wanfang data knowledge service platform and the Chinese biomedical literature database were collected to collect relevant literature. The search time range was Since the establishment of the library until September 2018. Metaanalysis was used to combine the results of the study and evaluate the stability and reliability of the results. Statistical processing was performed using RevMan 5.3 software. Results A total of 5 articles were included. Meta-analysis showed that, overall, comprehensive nursing measures can improve the oxygen partial pressure of non-invasive ventilator in patients with COPD and respiratory failure compared with general nursing measures [random effect model, WMD=10.59, 95%CI(7.04, 14.14),P<0.001], oxygen saturation [fixed effect model,WMD=7.28,95%CI(6.33, 8.24),P<0.001], p H [random effect model,WMD=0.10,95%CI(0.05,0.15),P<0.001],reducing the partial pressure of carbon dioxide [random effect model,WMD=-7.10,95%CI(-9.66,-6.20),P<0.001].Conclusion Comprehensive nursing measures have a positive effect on the improvement of PaO_2, PaCO_2, SaO_2 and p H in non-invasive ventilator in patients with COPD and respiratory failure.
Objective To evaluate the effect of comprehensive nursing measures on patients with COPD and respiratory failure treated with noninvasive ventilator.Methods The Chinese search term "comprehensive nursing" and "respiratory failure" were selected. The Chinese academic journal full-text database, the Weipu Chinese scientific journal full-text database, the Wanfang data knowledge service platform and the Chinese biomedical literature database were collected to collect relevant literature. The search time range was Since the establishment of the library until September 2018. Metaanalysis was used to combine the results of the study and evaluate the stability and reliability of the results. Statistical processing was performed using RevMan 5.3 software. Results A total of 5 articles were included. Meta-analysis showed that, overall, comprehensive nursing measures can improve the oxygen partial pressure of non-invasive ventilator in patients with COPD and respiratory failure compared with general nursing measures [random effect model, WMD=10.59, 95%CI(7.04, 14.14),P<0.001], oxygen saturation [fixed effect model,WMD=7.28,95%CI(6.33, 8.24),P<0.001], p H [random effect model,WMD=0.10,95%CI(0.05,0.15),P<0.001],reducing the partial pressure of carbon dioxide [random effect model,WMD=-7.10,95%CI(-9.66,-6.20),P<0.001].Conclusion Comprehensive nursing measures have a positive effect on the improvement of PaO_2, PaCO_2, SaO_2 and p H in non-invasive ventilator in patients with COPD and respiratory failure.
引文
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[7]于洁.综合护理干预在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者中的护理效果分析[J].国际护理学杂志,2016,35(16):2208-2210.
[8]张英,于伟.综合护理干预对无创正压通气治疗COPD合并Ⅱ型呼吸衰竭患者的影响[J].齐鲁护理杂志,2017,23(17):88-90.
[9]许伊佳,周静.综合护理干预对老年COPD合并呼吸衰竭无创机械通气患者排痰效果及肺换气功能的影响[J].医学临床研究,2018,35(2):406-408.
[2]孙金星.综合护理干预在老年慢性阻塞性肺疾病合并呼吸衰竭患者中的应用效果[J].当代护士,2017(10):34-36.
[3]Julian PT Higgins Senior Statistician Visiting Fellow.Chapter9.Analysing Data and Undertaking Meta-Analyses[M]//Cochrane Handbook for Systematic Reviews of Interventions:Cochrane Book Series.John Wiley&Sons,Ltd,2008.
[4]胡雁.循证护理学[M].北京:人民卫生出版社,2012:73-74.
[5]卢丹.无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭患者护理综合干预的效果评价[J].中国医药导报,2015,12(28):151-155.
[6]贡惠.无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭患者护理综合干预的效果分析[J].世界中医药,2016(b03):852-853.
[7]于洁.综合护理干预在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者中的护理效果分析[J].国际护理学杂志,2016,35(16):2208-2210.
[8]张英,于伟.综合护理干预对无创正压通气治疗COPD合并Ⅱ型呼吸衰竭患者的影响[J].齐鲁护理杂志,2017,23(17):88-90.
[9]许伊佳,周静.综合护理干预对老年COPD合并呼吸衰竭无创机械通气患者排痰效果及肺换气功能的影响[J].医学临床研究,2018,35(2):406-408.