非药物干预对新生儿重症监护室早产儿睡眠影响的Meta分析

    Non-Pharmacological Interventions for NICU Preterm Infants' Sleep Promotion: A Meta-Analysis

    • 摘要: 目的 采用Meta分析方法评估非药物干预措施对新生儿重症监护室早产儿睡眠的影响效果。 方法 检索CENTRAL、EMBASE、MEDLINE、CBM、CNKI、维普和万方数据库相关的随机对照研究,检索时间均为建库至2016年11月。由2名研究员独立筛选文献、评价文献质量和提取资料,运用RevMan5.3软件进行Meta分析。 结果 共纳入40项研究,Meta分析结果显示: ①新生儿个性化护理与评估未改善早产儿睡眠效率(均数差=6.90,95%可信区间 -4.83~18.62,P=0.25);②音乐疗法提高早产儿睡眠时间(均数差=1.95,95%可信区间1.79~2.11,P<0.000 01);③睡垫改造提高早产儿总睡眠效率和活跃睡眠效率(均数差=14.01,95%可信区间 8.05~19.98,P<0.000 01;均数差=9.51,95%可信区间2.75~16.27,P=0.006);④周期性光照提高早产儿睡眠时间(均数差=1.19,95%可信区间 0.16~2.22,P=0.02)。 结论 音乐疗法、睡垫改造和周期性光照具有改善早产儿睡眠的作用,但应用此类干预方法的研究证据不足,有待开展更多高质量随机对照研究加以验证。

       

      Abstract: Objective To assess the effects of non-pharmacological interventions for preterm infants' sleep. Methods The databases of CENTRAL, EMBASE, MEDLINE, CBM, Wanfang, CNKI and VIP were searched for randomized controlled trials(RCTs) which examined the effects of non-pharmacological interventions on preterm infants'sleep. Two reviewers independently screened literatures, extracted data, and assessed the quality of included studies. Meta analysis was performed by RevMan5.3 software. Results Forty RCTs were included in this review and interventions were varied. Results of meta-analysis showed that: ①NIDCAP had no significant effect on total sleep efficiency in preterm infants (MD=6.90,95%CI -4.83~18.62,P=0.25);②Music increased the sleep time of preterm infants (MD=1.95, 95%CI 1.79~2.11,P<0.000 01);③Mattress interventions had significant effect on total sleep efficiency and activesleepefficiency(AS%)(MD=14.01,95%CI 8.05~19.98,P<0.000 01;MD=9.51,95%CI 2.75~16.27,P=0.006); ④Cycled light had increased total sleep time(MD=1.19,95%CI 0.16~2.22,P=0.02). Conclusion Music, mattress and cycle light interventions may have beneficial effects on the sleep in preterm infants, but few articles were included in meta-analysis. So further high-quality researches are needed to strengthen the evidence base.

       

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