感官刺激对ICU患者意识水平影响的网状Meta分析

doi:10.3761/j.issn.2096-7446.2025.10.018

摘要/Abstract

摘要：

目的探讨不同实施人员、方式、频率及周期的感官刺激对ICU患者意识水平的有效性。方法检索PubMed、Cochrane Library、Web of Science、Embase、中国生物医学文献数据库、中国知网、万方数据库、维普数据库。纳入标准：研究对象为ICU患者的随机对照试验，试验组干预方式为不同方案的感官刺激，对照组干预方式为常规护理或其他方案，结局指标为干预后格拉斯哥昏迷量表评分。由2名研究人员独立筛选文献、提取数据并评价偏倚风险。采用R 4.3.2软件Gemtc包进行网状Meta分析，并通过累积排名曲线下面积计算干预方案的最佳排名概率。结果纳入14项研究，家属直接参与的感官刺激效果最佳，其次为家属间接参与、护士实施的刺激；多感官刺激优于听觉和触觉联合刺激及单一感官刺激；每天2次干预效果最佳，其次为每天3次、每天1次；周期10 d效果最佳，其次为>30 d、7 d、30 d、<7 d。结论基于有限的证据表明，感官刺激能有效改善ICU患者的意识水平，家属参与优于护士实施，多感官刺激优于单一刺激，干预周期至少为7 d才能产生较好的效果，每天2次的感官刺激是最佳频率。

关键词: 感官刺激, ICU患者, 意识状态, 网状Meta分析, 循证护理学

Abstract:

Objective To evaluate the effectiveness of sensory stimulation on ICU patients’ consciousness levels，considering different implementers，content，frequency，and duration. Methods A systematic search was conducted in PubMed，Cochrane Library，Web of Science，Embase，CNKI，Wanfang，and VIP databases. The inclusion criteria included randomized controlled trials involving ICU patients，the intervention methods for the experimental group were sensory stimulation with different protocols，while the intervention methods for the control group were routine nursing or other programs. The primary outcome was post-intervention Glasgow Coma Scale scores. Two researchers independently screened studies，extracted data，and assessed bias. A network meta-analysis using R 4.3.2 Gemtc package and the optimal ranking probability of intervention programs was calculated by accumulating the area under the ranking curve. Results Fourteen studies were included. Sensory stimulation with direct family involvement was most effective，followed by indirect family and nurse-led interventions. Multi-sensory stimulation outperformed combined or single-sensory approaches. Twice-daily interventions were most effective，followed by three times a day and once a day. 10 days interventions were most effective，followed by>30 days，7 days，30 days and <7 days. Conclusion Based on the limited evidence，sensory stimulation improves ICU patients’ consciousness，with family involvement and multi-sensory approaches yielding the best outcomes. The intervention period should be at least 7 days to produce good results，and twice daily sensory stimulation is the optimal frequency.

Key words: Sensory Stimulation, ICU Patients, Consciousness State, Network Meta-Analysis, Evidence Based Nursing

万称爽, 韩春彦, 徐辉辉, 王淑娟, 位兰玲, 陈付娟. 感官刺激对ICU患者意识水平影响的网状Meta分析[J]. 中华急危重症护理杂志, 2025, 6(10): 1245-1252.

WAN Chengshuang, HAN Chunyan, XU Huihui, WANG Shujuan, WEI Lanling, CHEN Fujuan. Effects of sensory stimulation on consciousness levels in ICU patients：a network meta-analysis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(10): 1245-1252.

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