文章摘要
引用本文:姚丽 丁楠楠 杨丽平 张志刚 张彩云 姜变通 蒋玲洁 吴雨晨 田金徽 魏花萍.重症患者转出ICU后认知损害危险因素的Meta分析[J].中国护理管理,2018,18(12):1634-1643 本文二维码信息
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重症患者转出ICU后认知损害危险因素的Meta分析
Risk factors for cognitive impairment after critical illness: a Meta-analysis
  
DOI:10.3969/j.issn.1672-1756.2018.12.011
中文关键词:  重症监护室  认知损害  ICU后综合征  危险因素  Meta分析
English Keywords:Intensive Care Unit (ICU)  cognitive impairment  post-intensive care syndrome  risk factors  Meta-analysis
基金项目:甘肃省自然科学基金(17JR5RA266)
作者单位
姚丽 丁楠楠 杨丽平 张志刚 张彩云 姜变通 蒋玲洁 吴雨晨 田金徽 魏花萍 兰州大学第一医院护理部730000 兰州市(姚丽丁楠楠张彩云姜变通蒋玲洁魏花萍)重症医学科(杨丽平张志刚吴雨晨)兰州大学循证医学中心(田金徽)兰州大学护理学院(姚丽丁楠楠姜变通蒋玲洁) 
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中文摘要:
      目的:通过Meta分析,系统评价重症患者转出ICU后发生认知损害的危险因素。方法:计算机检索PubMed、The Cochrane Library(2018年4期)、Web of Science、EMbase、中国生物医学文献数据库(CBM)、知网(CNKI)和万方数据库(Wanfang Data),辅以人工检索,检索时限均为建库至2018年4月。由2名研究者独立进行文献筛选、资料提取并评价纳入研究的偏倚风险,采用Revman 5.3软件进行Meta分析。结果:共纳入38篇文献,共计10 870例患者,经Meta分析,低氧血症、机械通气持续时间、Charlson共病指数、受教育水平、阿片类药物剂量、谵妄及其持续时间是重症患者转出ICU后认知损害的独立预测因素。结论:目前有关重症患者转出ICU后认知损害危险因素的研究证据尚不足,且认知损害诊断标准与随访时间差异较大,尚需要更多设计科学严谨、诊断标准和随访时间统一的原始研究。
English Summary:
      Objective: To identify the risk factors of post-ICU cognitive impairment by meta analysis. Methods: Databases including PubMed, The Cochrane Library (Issue 4, 2018), Web of Science, EMbase, CBM, CNKI, and Wanfang Data were searched to collect randomized control trials (RCTs), cohort studies and case-control studies about the risk factors of post-ICU cognitive impairment from inception to April 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was conducted using Revman 5.3. Results: Thirty-eight studies were recruited, including 10 870 cases. The hypoxemia, duration of mechanical ventilation, Charlson Comorbidity index, education level, opioid dose, delirium and duration of delirium were independent predictors of post-ICU cognitive impairment. Conclusion: Because of insufficient evidence on risk factors for post-ICU cognitive impairment and inconsistent evaluation methods of post-ICU cognitive impairment and different follow-up time, more strictly designed original studies are needed to identify the risk factors of post-ICU cognitive impairment.
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