舒适化浅镇静策略对ICU机械通气病人谵妄干预效果的Meta分析

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Abstract Objective：To evaluate the effect of early comfort using analgesia，minimal sedatives and maximal humane care strategy on delirium in ICU patients with mechanical ventilation.Methods：Randomized controlled trials on the effect of early comfort using analgesia，minimal sedatives and maximal humane care strategy on delirium in ICU patients with mechanically ventilated were retrieved from WanFang Database，CNKI，VIP，SinoMed，Web of Science，PubMed，EMbase and the Cochrane Library.The retrieval time was from inception to March 31，2022.Two researchers independently screened the literature，evaluated the quality and refined the data according to the inclusion and exclusion criteria.Then，RevMan 5.4 software was used for Meta-analysis.Results：A total of 22 RCTs were included.Meta-analysis results showed that compared with conventional care，early comfort using analgesia，minimal sedatives and maximal humane care strategy could reduce the incidence of delirium in ICU patients on mechanical ventilation［OR=0.42，95%CI（0.34，0.52），P<0.000 01］，and alleviate the persistent state of delirium ［MD=-1.30，95%CI（-1.48，-1.12），P<0.000 01］，shorten mechanical ventilation time［SMD=-1.23，95%CI（-1.57，-0.89），P<0.000 01］ and length of ICU stay ［SMD=-1.06，95%CI（-1.27，-0.85），P<0.000 01］and reduced the rate of death and treatment abandonment in hospital［OR=0.37，95%CI （0.22，0.60），P<0.000 1］.Conclusion：Current evidence shows that the early comfort using analgesia，minimal sedatives and maximal humane care strategy can reduce the incidence of delirium in ICU patients with mechanical ventilation，the rate of death in hospital，the rate of treatment abandonment，relieve the delirium duration，and reduce the length of mechanical ventilation and ICU hospitalization.

Keywords early comfort using analgesia，minimal sedatives and maximal humane care strategy，eCASH strategy；ICU;mechanical ventilation;delirium；length of hospital stay；Meta-analysis;evidence-based nursing

摘要 目的：系统评价舒适化浅镇静策略（eCASH策略）对重症监护室（ICU）机械通气病人谵妄的干预效果。（剩余12202字）