ICU转出患者睡眠障碍影响因素的系统评价和Meta分析

doi:10.3761/j.issn.2096-7446.2025.08.007

摘要/Abstract

摘要：

目的系统评价和Meta分析ICU转出患者睡眠障碍的影响因素。方法检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed、Embase、CINAHL、Cochrane Library、Web of Science数据库中有关ICU转出患者睡眠障碍影响因素的文献。检索时限为建库至2024年8月31日。采用Stata 18.0软件进行数据分析。结果共纳入9篇文献，包括6 558例患者，共提取出19项影响因素。将9项影响因素进行Meta合并，有意义的危险因素包括ICU入住时长（OR=1.136）、共病（OR=2.257）、抑郁（OR=1.497）、疼痛（OR=1.121）；有意义的保护因素包括生理健康（OR=0.897；MD=7.483）、心理健康（OR=0.845；MD=7.993）。剩余无法合并的影响因素进行系统评价，危险因素包括急性生理与慢性健康状况Ⅱ（Acute Physiology and Chronic Health Evaluation Ⅱ，APACHE Ⅱ）评分、气管切开、创伤后应激障碍（post-traumatic stress disorder，PTSD）、ICU感染、血清大麻素水平、药物滥用；保护因素包括ICU转出时侵入性管路移除数量、血清褪黑素水平、年龄、病房睡眠质量。结论 ICU转出患者睡眠障碍受多种因素影响，涉及治疗、生理、心理方面。医护人员应尽早、全面、动态评估ICU转出患者的睡眠状况，给予个体化和精准化的预防及干预措施。同时，鉴于纳入文献数量和质量限制，上述部分研究结果需要未来更多高质量研究进一步验证。

关键词: ICU转出患者, 睡眠障碍, 影响因素, 系统评价, Meta分析, 循证护理学

Abstract:

Objective To systematically review and meta-analyze the influencing factors of sleep disorders in post-ICU patients. Methods We searched related literature on influencing factors of sleep disorders in post-ICU patients in CNKI，Weipu Database，Wanfang Database，SinoMed，PubMed，Embase，CINAHL，Cochrane Library，and Web of Science，the retrieval time was from inception of the database to August 31，2024. All analyses were performed using Stata version 18.0. Results A total of 9 studies，involving 6 558 patients and 19 influencing factors，met the inclusion criteria. Nine influencing factors were pooled for meta-analysis. The identified significant risk factors included length of ICU stay（OR=1.136），comorbidity（OR=2.257），depression（OR=1.497），and pain（OR=1.121）. Significant protective factors included physical health（OR=0.897；MD=7.483），and mental health （OR=0.845；MD=7.993）. The remaining influencing factors，which could not be pooled，were systematically reviewed. The risk factors included Acute Physiology and Chronic Health Evaluation（APACHE） Ⅱ score，tracheotomy，post-traumatic stress disorder（PTSD），ICU infections，serum cannabinoid levels，and drug abuse. Protective factors included the number of invasive tube removals at ICU discharge，serum melatonin levels，age，and ward sleep quality. Conclusion Sleep disorders in post-ICU patients are influenced by various factors，including therapeutic，physiological，and psychological aspects. Doctors and nurses should evaluate the sleep status of post-ICU patients as early as possible，comprehensively，and dynamically，providing individualized and precise prevention and intervention measures. However，due to limitations in the quantity and quality of the included studies，some findings require further verification through higher-quality research in the future.

Key words: Post-ICU Patients, Sleep Disorders, Influencing Factors, Systematic Review, Meta-Analysis, Evidence-Based Nursing

姜伟林, 王莉, 黄真真, 燕然, 易佳, 庄一渝. ICU转出患者睡眠障碍影响因素的系统评价和Meta分析[J]. 中华急危重症护理杂志, 2025, 6(8): 945-952.

JIANG Weilin, WANG Li, HUANG Zhenzhen, YAN Ran, YI Jia, ZHUANG Yiyu. Influencing factors of sleep disorders in post-ICU patients：a systematic review and meta-analysis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 945-952.

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