中西医临床护理路径在我国糖尿病患者干预效果的系统评价

发布时间：2018-05-16 11:39

本文选题：临床护理路径 + 糖尿病　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:对西医临床护理路径、中西医结合临床护理路径在我国糖尿病患者中的应用效果进行系统评价,为今后糖尿病患者的临床护理提供科学依据。方法:计算机检索中国生物医学数据库、知网、维普、万方、Cochrane图书馆、JBI循证卫生保健数据库、Medline、PubMed等中英文数据库,纳入符合标准的研究。两个评价员首先独立地阅读文章题目,对相关文献再阅读摘要,关键词,将符合纳入标准的文献进行分类评价。不同意见讨论解决由第三者判断。对纳入研究的方法学质量从随机顺序的产生、分配隐藏、对研究对象及干预实施者采取盲法、对结果测评者采用盲法、结局指标的完整性、选择性报告研究结果的可能性、其他方面的偏倚7方面进行评价,用RevMan 5.3软件进行统计分析。对同质性较好的多个研究结果,用固定效应模型合并分析;对有统计学异质性的研究,用随机效应模型合并分析;对有临床或方法学异质性的研究,用亚组分析、meta回归和放弃meta分析来处理。连续性变量采用加权均数差(WMD)表示、二分类变量采用相对危险度(RR),二者均计算95%的可信区间(CI)。结果:西医临床护理路径纳入81个研究,共9320例患者。Meta分析结果显示:西医临床护理路径在2型糖尿病患者中干预2周后患者健康知识达标率、满意率、依从性均高于常规护理组,空腹血糖值、餐后2小时血糖值均低于常规护理组;干预1周后患者依从性高于常规护理组,空腹血糖值、餐后2小时血糖值低于常规护理组,健康知识达标率、满意率与常规护理组没有区别。中西医结合临床护理路径纳入6个研究,共752例患者。我们对患者健康知识达标率、满意率、住院时间这3个指标采用meta分析,剩余3个指标进行了描述性分析。Meta分析结果显示中西医结合临床护理路径组患者健康知识达标率、满意率高于常规护理组,住院时间低于常规护理组。结论:在糖尿病患者中实施干预2周的临床护理路径模式,可有效提升糖尿病患者健康知识达标率、满意率、依从性,降低住院时间、住院费用,改善患者血糖水平,值得临床推广应用。由于纳入文献质量较低,希望今后有更多更为严谨的临床随机对照试验来进一步验证。
[Abstract]:Objective: to systematically evaluate the clinical nursing path of Western medicine and the clinical nursing path of integrated traditional Chinese and Western medicine in the patients with diabetes in China and provide scientific basis for the clinical nursing of diabetic patients in the future. Methods: the computer retrieval of Chinese biomedical database, the Chinese medicine network, VP, Wanfang, Cochrane library, JBI evidence-based health care. Database, Medline, PubMed and other Chinese and English databases, which are included in the standard study. Two evaluators first read the title of the article independently, read the related literature again and read the summary, and the key words will be classified and evaluated according to the standard. The different opinions are discussed and resolved by the third. The methodological quality of the included study is from random. In order to produce, distribute hidden, take blind law to the research object and the intervention implementer, evaluate the result evaluator with the blind method, the completeness of the outcome index, the possibility of the selective report on the result of the study, the 7 aspects of the other aspects, and use the RevMan 5.3 software to carry out the unified analysis. Combined analysis of effect models; combined analysis of random effect models for statistical heterogeneity; study of clinical or methodological heterogeneity, subgroup analysis, meta regression and abandonment of meta analysis. The continuity variables were weighted mean number difference (WMD), two classified variables used relative risk degree (RR), and the two all calculated 95% Results: CI. Results: the clinical nursing path of Western medicine was included in 81 studies. A total of 9320 patients were analyzed by.Meta analysis. The results showed that the health knowledge standard rate, satisfaction rate and compliance of the western medicine clinical nursing pathway were higher than those of the conventional nursing group after 2 weeks of intervention in type 2 diabetes patients, and the value of fasting blood glucose and 2 hours after meal were lower than those of conventional nursing. After 1 weeks of intervention, the compliance of the patients was higher than that of the conventional nursing group. The value of fasting blood glucose and the 2 hour postprandial blood glucose were lower than that of the conventional nursing group. The rate of health knowledge reached the standard and the satisfaction rate was not different from that of the conventional nursing group. The clinical nursing path of the combination of Chinese and Western medicine was included in 6 studies and 752 patients. The 3 indexes of time were analyzed by meta, and the remaining 3 indexes were analyzed by the descriptive analysis of.Meta. The results showed that the health knowledge of the patients was higher than that of the conventional nursing group and the time of hospitalization was lower than that of the conventional nursing group. Conclusion: the clinical nursing path mode of intervention for 2 weeks in the patients with diabetes was carried out. It can effectively improve the health knowledge standard rate, satisfaction rate, compliance, reduce the time of hospitalization, hospitalization expenses, and improve the blood glucose level of patients. It is worthy of clinical application. Because of the low quality of the literature, we hope to have more rigorous and more rigorous clinical randomized trial to verify it in the future.

【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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