音乐干预对住院早产儿生理指标作用的系统评价和Meta分析

摘要

Objective To systematically review the effectiveness of music intervention on the regulation of physiological parameters of preterm infants during hospitalization.Methods Databases including CNKI,WANFANG,Pubmed,CINAHL,Embase and Cochrane Library were electronically searched for the randomized controlled trials(RCTs)on the effect of music intervention on the physiological parameters of hospitalized preterm infants from inception to April 18,2017.Participants were stable preterm infants with normal hearing.The experimental group was treated with music intervention(without limitation of music type,intervention time,frequency and duration).During the intervention,premature infants did not receive any invasive stimuli,and were in a calm state.The control group did not receive any music intervention.Outcome indicators included oxygen saturation,heart rate,respiratory frequency and other physiological indicators.The methodological quality of the literatures was evaluated by JBI literature quality evaluation tool and data were analyzed by RevMan 5.3 software.Results A total of nine studies met the inclusion and exclusion criteria,and five of them with quality A or B(all in English)were analyzed.All the five studies reported oxygen saturation,and four reported heart rate and respiratory rate.Meta-analysis showed that the difference of oxygen saturation,heart rate and respiration rate of preterm infants was not statistically significant between the intervention group and the control group.According to the different types of music and different forms of music implementation,subgroup analysis of lullaby,recorded music and live music were conducted.Results showed that the oxygen saturation of the recorded music group was higher than that of the control group [MD=0.81,95%CI: 0.03~1.59),Z=2.05,P=0.04] and there was no significant difference in oxygen saturation,heart rate and respiratory rate between the other subgroups and the control group.Conclusion The effect of music intervention on regulating the vital signs of premature infants is still unclear.In view of the absence of RCTs with good quality in this field,it is necessary to carry out more large-scale and high-quality RCTs to further explore the effectiveness of music intervention on physical parameters of hospitalized preterm infants.%目的 评价音乐干预对早产儿住院期间生理指标的调节作用.方法 系统检索中国知网、万方数据库、PubMed、CINAHL、Embase和Cochrane Library数据库从建库至2017年4月18日的文献中关于音乐干预对住院早产儿(病情稳定、听力正常)生理指标作用的RCT,干预期间早产儿不接受侵入性刺激、处于平静状态,试验组给予音乐干预(音乐类型、干预时机、次数和时间不限),对照组不予音乐干预.结局指标为氧饱和度、心率和呼吸频率.采用JBI文献质量评价工具对纳入的RCT进行方法学质量评价.采用RevMan 5.3软件进行Meta分析.结果 9篇文献符合本文的纳入标准和排除标准,质量评价后纳入5篇质量为A或B的文献(均为英文).5篇文献均报道了氧饱和度,4篇文献报道了心率和呼吸频率.Meta分析显示,试验组和对照组氧饱和度、心率和呼吸频率差异均无统计学意义.进一步行亚组分析,根据音乐干预类型提取摇篮曲干预亚组,根据音乐实施形式的不同提取录播音乐亚组和现场演奏音乐亚组,结果显示,仅录播音乐干预组氧饱和度高于对照组[MD=0.81,95%CI:0.03~1.59),Z=2.05,P=0.04].结论 音乐干预对调节早产儿生理指标的作用不明确,鉴于该领域高质量RCT文献少,需开展更多大样本高质量的RCT进一步探讨.