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健康教育对我国肺癌患者术后恢复影响的Meta分析
作者:金程 张艳鹤  
单位:中国医科大学附属第四医院胸外科
关键词:健康教育 肺癌 术后恢复 Meta分析 
分类号:
出版年·卷·期(页码):2014·42·第三期(241-245)
摘要:

目的:本研究运用循证医学Meta分析方法探讨健康教育对我国肺癌患者术后恢复的影响。方法:采用主题词结合自由词原则,电子检索国内中文数据库收集相关文献,根据纳入标准筛选文献并提取数据,采用STATA 12.0软件进行Meta分析。结果:本研究共计纳入6项临床对照研究,包括498例接受手术切除的肺癌患者,其中健康教育组247例,常规组251例。Meta分析结果显示,健康教育组患者术后生理功能评分(SMD = 3.89, 95%CI = 1.42~6.36, P = 0.002)、咳嗽程度评分(SMD = -0.52, 95%CI = -0.92~-0.12, P = 0.010)、痰液粘稠度评分(SMD = -0.81, 95%CI = -1.16~-0.46, P < 0.001)、排痰难度评分(SMD = -0.97,95%CI = -1.31~-0.63, P <0.001)和肺部啰音评分(SMD = -0.71, 95%CI = -1.06~-0.36, P <0.001)等指标均优于常规组患者。健康教育组患者术后肺不张(OR = 0.30, 95%CI = 0.15~0.59, P = 0.0005)、肺部感染(OR = 0.30, 95%CI = 0.15~0.59, P < 0.001)、呼吸衰竭(OR = 0.31, 95%CI = 0.14~0.68, P = 0.004)等并发症发生率亦显著低于常规组。此外,健康教育组患者的护理满意率(OR = 6.75, 95%CI = 1.84~24.85, P = 0.004)和治疗主动率(OR = 5.28,95%CI = 1.38~20.16,P = 0.010)均高于常规组。结论:健康教育可显著改善肺癌患者术后适应状况和肺部症状,降低术后并发症发生率,并可有效地提高患者的护理满意率和主动率。

Objective: This meta-analysis aimed to investigate the influence of health education on postoperative recovery for patients with lung cancer. Methods: Data collection of relevant clinical controlled trials were extensively selected from Chinese databases. Meta-analysis was conducted by STATA 12.0 software. Results: According to inclusion criteria, 16 case-control studies were assessed with a total of 1627 lung cancer (LC) patients, including 808 LC patients in the observation group and 813 LC patients in control group. Meta-analysis results showed that health education may improve physiological function (SMD = 3.89, 95%CI = 1.42~6.36, P = 0.002), degree of cough (SMD = -0.52, 95%CI = -0.92~-0.12, P = 0.010), density of phlegm (SMD = -0.81, 95%CI = -1.16~-0.46, P < 0.001), difficulty in expectoration (SMD = -0.97,95%CI = -1.31~-0.63, P <0.001) and pneumonic rales (SMD = -0.71, 95%CI = -1.06~-0.36, P <0.001) for LC patients. Health education may also decrease the rate of postoperative atelectasis (OR = 0.30, 95%CI = 0.15~0.59, P < 0.001), pulmonary infection (OR = 0.30, 95%CI = 0.15~0.59, P < 0.001), pulmonary failure OR = 0.31, 95%CI = 0.14~0.68, P = 0.004). In addition, the nursing satisfaction (OR = 6.75, 95%CI = 1.84~24.85, P = 0.004) and active rate (OR = 5.28,95%CI = 1.38~20.16,P = 0.010) could be improved by health education. Conclusion: The present meta-analysis indicates that health education may significantly improve postoperative adaptive responses and pulmonary symptoms for patients with lung cancer.

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