天津护理 ›› 2026, Vol. 34 ›› Issue (1): 72-76.DOI: 10.3969/j.issn.1006-9143.2026.01.012

• 循证护理 • 上一篇    下一篇

身体约束与成人气管插管非计划性拔管风险关系的Meta分析

孙艳玲 于阳 夏欣华 王宇霞 李雅楠 张紫君   

  1. (天津市泰达医院,天津 300457)
  • 出版日期:2026-02-28 发布日期:2026-02-25

A meta-analysis examining the correlation between physical restraint and the incidence of unplanned extubation following tracheal intubation

SUN Yanling, YU Yang, XIA Xinhua, WANG Yuxia, LI Yanan, ZHANG Zijun   

  1. (TEDA Hospital, Tianjin 300457)
  • Online:2026-02-28 Published:2026-02-25

摘要: 目的:系统评价身体约束与成人气管插管患者非计划性拔管(Unplanned Endotracheal Extubation,UEE)的关系。方法:检索万方、中国知网、维普、中国生物医学文献数据库、中华医学期刊全文数据库、PubMed、Embase、Cochrane Library、CINAHL等中英文数据库,纳入自建库至2025年8月31日期间发表的关于身体约束与非计划性拔管风险关系的队列研究或病例对照研究。由2名研究人员独立进行文献筛选、资料提取及文献质量评价,并使用Stata进行Meta分析。结果:共纳入8篇文献,涉及1 662例ICU气管插管患者。风险关系Meta分析结果显示,使用身体约束的患者发生UEE的风险高于未使用身体约束的患者[OR=3.44(2.52~4.72),P<0.001]。亚组分析结果均显示使用身体约束的患者发生UEE的风险高于未使用身体约束的患者。结论:现有证据表明身体约束会增加UEE的风险,但还需更多高质量的队列研究以及标准化的约束实践以进一步验证。

关键词: 身体约束, 气管插管, 非计划性拔管, 风险关系, Meta分析

Abstract: Objective: To systematically evaluate the association between physical restraint and unplanned endotracheal extubation (UEE) among adult intubated patients. Methods: Wanfang Data, CNKI, VIP, SinoMed, CMJ Full-Text Database, PubMed, Embase, Cochrane Library and CINAHL were searched for cohort or case-control studies on the association between physical restraint and UEE risk, published from inception to 31 August 2025. Two reviewers independently conducted literature screening, data extraction, and evaluation of literature quality. Meta-analysis was performed with STATA software. Results: Eight studies involving 1 662 ICU intubated patients were included. The meta-analysis showed that physical restraint use was associated with a significantly increased risk of unplanned extubation (UEE) [OR=3.44(2.52~4.72), P<0.001]. Subgroup analyses demonstrated that the risk of UEE was higher in patients whos use physical restraint compared to those who did not. Conclusion: Current evidence suggests that physical restraints increase the risk of UEE, but further validation requires more high-quality cohort studies and standardized restraint definitions.

Key words: Physical restraint, Tracheal intubation, Unplanned extubation, Risk relationship, Meta-analysis