ICU成人患者呼吸机相关性肺炎危险因素的meta分析(1)
[摘要] 目的 系統评价重症监护室(ICU)成人患者呼吸机相关性肺炎(VAP)的危险因素。 方法 检索中国知网、万方、维普、Cochrane图书馆、PubMed和Web of Science，收集国内外公开发表的ICU成人患者VAP危险因素的研究，检索时间为2009年1月～2018年12月。由2名评估员遵循纳排标准独立进行文献筛选，如有分歧则请第三方评估，共同讨论筛选出符合纳入标准的文献。应用Revman 5.3软件进行meta分析，并计算各危险因素的合并比值比(OR)。 结果 共纳入12篇文章，均为病例对照研究。年龄≥60岁、机械通气时间≥7 d、昏迷、急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)≥15分、使用抗生素、使用制酸剂、气管切开是ICU成人患者发生VAP的危险因素(OR > 1，P < 0.05)。 结论 高龄、机械通气时间较长、昏迷、APACHEⅡ评分较高、使用抗生素、使用制酸剂、气管切开的ICU成人患者更易发生VAP。胃肠内营养是否为ICU成人患者VAP的危险因素，可能与胃肠内营养给予的方式相关。
[关键词] 重症监护病房;呼吸机相关性肺炎;危险因素;meta分析
[中图分类号] R563.1 [文献标识码] A [文章编号] 1673-7210(2020)04(b)-0102-06
Meta-analysis of risk factors for ventilator-associated pneumonia in adult patients with ICU
FANG Jinlin HUANG Yanzhou YE Hongfang
Department of Hematology， Nanjing Drum Tower Hospital， the Affiliated of Nanjing University Medical School， Jiangsu Province， Nanjing 210008， China
[Abstract] Objective To systematically evaluate the risk factors of ventilator-associated pneumonia (VAP) in adult patients in the intensive care unit (ICU). Methods Chinese Knowledge Network， Wanfang， VIP， PubMed， Cochrane Library and Web of Science were searched to collect publicly published studies on the risk factors of VAP in adult patients with ICU at home and abroad， from January 2009 to December 2018. Literature review was conducted independently by two evaluators following the criteria for inclusion. If there were differences， a third-party evaluation was conducted to discuss and select the literature that met the inclusion criteria. Revman 5.3 software was used for meta-analysis and the combined odds ratio (OR) of each risk factor was calculated. Results A total of 12 articles were included in the study， all of which were case-control studies. Age≥60 years， mechanical ventilation time≥7 days， coma， acute physiological and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) ≥ 15 points， use of antibiotics， antacids， and tracheotomy are risk factors for VAP in adult patients with ICU (OR > 1， P < 0.05). Conclusion Adult patients in ICU who are older， have longer mechanical ventilation， are in a coma， have higher APACHE Ⅱ scores， use antibiotics， use antacids， and have tracheostomy are more likely to cause VAP. Whether parenteral nutrition is a risk factor for VAP in adult patients with ICU may be related to the way parenteral nutrition is administered.
[Key words] Intensive care unit; Ventilator-associated pneumonia; Risk factors; Meta-analysis, 百拇医药(方金林 黄燕周 叶红芳)
[关键词] 重症监护病房;呼吸机相关性肺炎;危险因素;meta分析
[中图分类号] R563.1 [文献标识码] A [文章编号] 1673-7210(2020)04(b)-0102-06
Meta-analysis of risk factors for ventilator-associated pneumonia in adult patients with ICU
FANG Jinlin HUANG Yanzhou YE Hongfang
Department of Hematology， Nanjing Drum Tower Hospital， the Affiliated of Nanjing University Medical School， Jiangsu Province， Nanjing 210008， China
[Abstract] Objective To systematically evaluate the risk factors of ventilator-associated pneumonia (VAP) in adult patients in the intensive care unit (ICU). Methods Chinese Knowledge Network， Wanfang， VIP， PubMed， Cochrane Library and Web of Science were searched to collect publicly published studies on the risk factors of VAP in adult patients with ICU at home and abroad， from January 2009 to December 2018. Literature review was conducted independently by two evaluators following the criteria for inclusion. If there were differences， a third-party evaluation was conducted to discuss and select the literature that met the inclusion criteria. Revman 5.3 software was used for meta-analysis and the combined odds ratio (OR) of each risk factor was calculated. Results A total of 12 articles were included in the study， all of which were case-control studies. Age≥60 years， mechanical ventilation time≥7 days， coma， acute physiological and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) ≥ 15 points， use of antibiotics， antacids， and tracheotomy are risk factors for VAP in adult patients with ICU (OR > 1， P < 0.05). Conclusion Adult patients in ICU who are older， have longer mechanical ventilation， are in a coma， have higher APACHE Ⅱ scores， use antibiotics， use antacids， and have tracheostomy are more likely to cause VAP. Whether parenteral nutrition is a risk factor for VAP in adult patients with ICU may be related to the way parenteral nutrition is administered.
[Key words] Intensive care unit; Ventilator-associated pneumonia; Risk factors; Meta-analysis, 百拇医药(方金林 黄燕周 叶红芳)
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