综合护理对肺结核患者治疗效果的Meta分析

doi:10.19982/j.issn.1000-6621.20250281

中国防痨杂志 ›› 2025, Vol. 47 ›› Issue (12): 1635-1643.doi: 10.19982/j.issn.1000-6621.20250281

综合护理对肺结核患者治疗效果的Meta分析

吴登助¹, 沈灵芬², 郑君³, 陆天奇⁴, 郑逸⁵, 潘蕾¹(), 严辰希¹

¹杭州市红十字会医院结核病诊疗中心,杭州 310003
²浙江省台州医院心胸外科,台州 318000
³杭州市上城区南星街道社区卫生服务中心,杭州 310000
⁴杭州市临安区第一人民医院急诊医学科,杭州 310000
⁵浙江特殊教育职业学院康复技术系,杭州 310023

收稿日期:2025-07-07 出版日期:2025-12-10 发布日期:2025-11-28
通信作者: 潘蕾,Email:5295492@qq.com
基金资助:
杭州市生物医药和健康产业发展扶持专项项目(2023WJC117);浙江省中医药管理局(2023ZL559);中国医药教育协会项目(T-2025033)

Meta-analysis on effectiveness of comprehensive nursing care on pulmonary tuberculosis patients

Wu Dengzhu¹, Shen Lingfen², Zheng Jun³, Lu Tianqi⁴, Zheng Yi⁵, Pan Lei¹(), Yan Chenxi¹

¹Tuberculosis Treatment Center, Hangzhou Red Cross Hospital, Hangzhou 310003, China
²Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province, Taizhou 318000, China
³Nanxing Street Community Health Service Center, Shangcheng District, Hangzhou 310000, China
⁴Department of Emergency Medicine, Lin'an District First People's Hospital, Hangzhou 310000, China
⁵Department of Rehabilitation Technology, Zhejiang Vocational College of Special Education, Hangzhou 310023, China

Received:2025-07-07 Online:2025-12-10 Published:2025-11-28
Contact: Pan Lei, Email: 5295492@qq.com
Supported by:
Hangzhou Special Project for Supporting the Development of Biomedical and Health Industry(2023WJC117);Zhejiang Provincial Administration of Traditional Chinese Medicine(2023ZL559);China Medical Education Association(T-2025033)

摘要/Abstract

摘要：

目的: 系统评价综合护理对肺结核患者治疗效果的影响。方法: 系统性检索中国知网、PubMed数据库和Embase等数据库中符合标准的随机对照试验。评估综合护理对肺结核患者治疗效果的影响,包括治疗依从性、自我管理能力及心理健康指标。检索时限为2010年1月1日至2025年7月1日。由2名研究者独立进行文献筛选、数据提取及质量评价,采用RevMan 5.4软件进行Meta分析。结果: 共有16篇文献纳入研究。Meta分析结果显示,与常规治疗相比,综合护理显著提高了肺结核患者用药的治疗依从率(OR=4.87,95%CI:3.36~7.06,P<0.01)。在两组自我管理能力测评量表的Meta分析中,观察组在自我概念(MD=5.24,95%CI:4.69~5.79,P<0.01)、自我责任感(MD=5.08,95%CI:2.09~8.08,P<0.01)、自我护理技巧(MD=7.85,95%CI:7.16~8.54,P<0.01)、健康知识水平(MD=8.00,95%CI:7.13~8.87,P<0.01)方面得分显著高于常规护理组。与常规护理相比,观察组SAS评分显著降低(MD=-7.09,95%CI:-9.67~-4.51,P<0.01),SDS评分也明显低于常规护理患者(MD=-7.17,95%CI:-9.13~-5.21,P<0.01)。结论: 综合护理显著提高了肺结核患者的治疗依从性、自我管理能力,并改善了心理健康指标,医护人员可根据结核病患者个性化特点,加强综合护理,改善治疗效果。

关键词: 结核, Meta分析, 护理, 疾病管理

Abstract:

Objective: To systematically evaluate the effectiveness of comprehensive nursing on the treatment outcome of patients with pulmonary tuberculosis. Methods: A systematic search was conducted in CNKI, PubMed and Embase databases for randomized controlled trials that met certain criteria. The effectiveness of comprehensive nursing on the treatment outcomes of pulmonary tuberculosis patients, including treatment compliance, self-management ability and mental health indicators, was evaluated. The search period was from January 1, 2010 to July 1, 2025. Two researchers independently conducted literature screening, data extraction and quality evaluation. Meta-analysis was performed using RevMan 5.4 software. Results: A total of 16 articles were included in the study. The meta-analysis results showed that compared with conventional treatment, comprehensive care significantly increased the treatment compliance rate of tuberculosis patients (OR=4.87, 95%CI: 3.36-7.06, P<0.01). In meta-analysis of self-management ability assessment scales of the two groups, the observation group scored significantly higher than the conventional care group in self-concept (MD=5.24, 95%CI: 4.69-5.79, P<0.01), self-responsibility (MD=5.08, 95%CI: 2.09-8.08, P<0.01), self-care skills (MD=7.85, 95%CI: 7.16-8.54, P<0.01), and health knowledge level (MD=8.00, 95%CI: 7.13-8.87, P<0.01). Compared with conventional care, the observation group had significantly lower SAS scores (MD=-7.09, 95%CI: -9.67 - -4.51, P<0.01) and SDS scores (MD=-7.17, 95%CI: -9.13 --5.21, P<0.01). Conclusion: Comprehensive nursing significantly enhanced treatment compliance, self-management ability of patients with pulmonary tuberculosis, and improved their mental health indicators. Medical staff can strengthen comprehensive nursing based on individual characteristics of tuberculosis patients to improve the treatment outcome.

Key words: Tuberculosis, Mate-analysis, Nursing care, Disease management

中图分类号:

吴登助, 沈灵芬, 郑君, 陆天奇, 郑逸, 潘蕾, 严辰希. 综合护理对肺结核患者治疗效果的Meta分析[J]. 中国防痨杂志, 2025, 47(12): 1635-1643. doi: 10.19982/j.issn.1000-6621.20250281

Wu Dengzhu, Shen Lingfen, Zheng Jun, Lu Tianqi, Zheng Yi, Pan Lei, Yan Chenxi. Meta-analysis on effectiveness of comprehensive nursing care on pulmonary tuberculosis patients[J]. Chinese Journal of Antituberculosis, 2025, 47(12): 1635-1643. doi: 10.19982/j.issn.1000-6621.20250281

图/表 14

图1

表1

纳入文献的基本特征

纳入文献	年份	研究类型	总样本 (例)	地域	对照组∶观察组样本量	对照组干预措施	观察组干预措施	时长	结局事件
袁姣姣^[10]	2024	随机对照试验	166	中国	83∶83	常规护理	责任制分组护理质量管理模式	15d	a,b
谢星等^[11]	2024	随机对照试验	88	中国	44∶44	常规护理	MDT式延续护理干预	6个月	a,b,c
罗世珍^[12]	2014	随机对照试验	80	中国	38∶39	常规护理(不完全管理)	完全管理模式	2年	a
杨凤姣等^[13]	2024	随机对照试验	82	中国	41∶41	常规护理	延续性护理干预	6个月	a,b
韩宇等^[14]	2024	随机对照试验	90	中国	45∶45	常规护理	临床护理路径	住院期间	a,c
钟凯惠等^[15]	2013	随机对照试验	160	中国	80∶80	DOTS管理下的常规护理	护士与家庭联合督导	5个月	a
张晓蓉等^[16]	2015	随机对照试验	76	中国	38∶38	一般护理	饮食护理、心理护理、健康教育	6个月	a
李恒等^[17]	2024	随机对照试验	50	中国	25∶25	常规护理	优质服务护理	住院期间	a
陈兰玉^[18]	2024	随机对照试验	80	中国	40∶40	基础护理措施	多学科协作护理	治疗期	a
王雪豫等^[19]	2013	随机对照试验	80	中国	40∶40	常规护理	连续护理干预	6个月	a,c
刘晓霞等^[20]	2024	随机对照试验	104	中国	52∶52	常规护理	循环护理干预措施	1年内	a
张宁等^[21]	2024	随机对照试验	100	中国	50∶50	常规护理	优质护理	住院期间	a
左玉杰等^[22]	2024	随机对照试验	74	中国	37∶37	常规护理	医院-家庭联合延伸护理服务	6个月	a
Xu等^[23]	2021	随机对照试验	150	中国	75∶75	常规护理	综合护理干预联合呼吸功能锻炼	住院期间 (>2周)	b
Lu等^[24]	2021	随机对照试验	85	中国	41∶44	常规护理	针对性护理并结合心理疏导	1~2年	a
Chen等^[25]	2024	随机对照试验	114	中国	57∶57	常规护理管理	精细化护理管理干预	住院期间	a

表1

图2

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图5

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图8

图9

图10

图11

图12

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综合护理对肺结核患者治疗效果的Meta分析

Meta-analysis on effectiveness of comprehensive nursing care on pulmonary tuberculosis patients

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