目的 系统评价虚拟现实(VR)技术在全麻手术患儿术前焦虑中的应用效果，为临床规范有效地应用VR技术提供证据。方法 检索PubMed、EMBASE、Cochrane Library、OVID(JBI)循证卫生保健数据库、Web of Science、CINAHL、中国生物医学文献数据库、CNKI和万方数据库、维普数据库中应用VR技术对全麻手术患儿进行术前焦虑干预的随机对照试验和临床对照试验，采用Cochrane偏倚风险评估工具2。0对文献质量进行评价，采用RevMan 5。3软件进行Meta分析。结果 共纳入12项研究，984例患者。Meta分析结果显示，与传统方法相比，VR技术的应用可显著降低患儿术前焦虑，尤其是麻醉诱导时的焦虑水平(MD=-0。79，95%CI:-0。98～-0。61，P<0。01)，提高患儿麻醉诱导依从性(RR=0。46，95%CI:0。30～0。70，P<0。01)，但对患儿苏醒期躁动水平无明显影响(MD=-0。14，95%CI:-0。64～0。36，P=0。28)。VR技术在是否能影响患儿苏醒期躁动发生率、术后行为改变、疼痛水平、生命体征、父母/监护人焦虑水平或满意度、麻醉镇痛药物应用等方面，目前尚无明确结论。结论 应用VR技术可以有效减轻患儿术前焦虑，尤其是麻醉诱导时的焦虑水平，提升患儿麻醉诱导依从性，保障手术安全进行，是一种有效的辅助性干预手段。但其是否能减少患儿麻醉及镇痛药物需要、术后行为改变及苏醒期躁动发生，稳定患儿生命体征，降低患儿疼痛水平，减轻患儿父母/监护人焦虑，提升患儿父母/监护人满意度等仍无定论。
Intervention effects of virtual reality technology for preoperative anxiety in children undergoing general anesthesia surgery:a meta-analysis
Objective To systematically evaluate the application effect of virtual reality(VR)technology on preoperative anxiety in pediatric patients undergoing general anesthesia surgery,and to provide evidence for the standardized and effective application of VR technology in clinical practice.Methods Randomized controlled trials and clinical controlled trials of preoperative anxiety intervention in pediatric patients undergoing general anesthesia surgery using VR technology were retrieved from PubMed,EMBASE,Cochrane Library,OVID(JBI)EBP Database,Web of Science,CINAHL,CBM,CNKI,Wanfang Data,and VIP Database.The quality of literatures were evaluated using the Cochrane Bias Risk Assessment Tool 2.0,and meta-analysis was performed using RevMan 5.3 software.Results A total of 12 studies involving 984 patients were included.The meta-analysis results showed that compared with traditional methods,the application of VR technology significantly reduced preoperative anxiety of pediatric patients,especially at the time of anesthesia induction(MD=-0.79,95%CI:-0.98～-0.61,P<0.01),and improved anesthesia induction compliance in pediatric patients(RR=0.46,95%CI:0.30～0.70,P<0.01),but had no significant effect on the level of emergence agitation during the recovery period(MD=-0.14,95%CI:-0.64～0.36,P=0.28).There was currently no clear conclusion on whether VR technology can affect the incidence of agitation in pediatric patients during the recovery period,postoperative behavioral changes,pain levels,vital signs,parental/guardian anxiety levels or satisfaction,and the application of anesthetic analgesic drugs.Conclusion The application of VR technology can effectively alleviate preoperative anxiety in pediatric patients,especially at the time of anesthesia induction,improve anesthesia induction compliance in pediatric patients,and ensure the safe conduct of surgery.It is an effective auxiliary intervention.However,whether it can reduce the need for anesthetic and analgesic drugs,postoperative behavioral changes,and the incidence of emergence agitation during recovery period in pediatric patients,stabilize vital signs in pediatric patients,reduce pain levels in pediatric patients,alleviate anxiety in parents/guardians,and improve satisfaction in parents/guardians remains inconclusive.
万方数据
维普
