我国新生儿呼吸机通气相关并发症及危险因素的系统评价  

A systematic evaluation on ventilator- associated complications and their risk factors in neonates in China

作　　者：肖政[1,2] 汪成琼 胡世芸[2] 邱隆敏[1,2] 余昌胤[1] 

机构地区：[1]遵义医学院循证医学中心循证医学教育部网上合作研究中心遵义医学院分中心,贵州遵义563003 [2]遵义医学院附属医院

出　　处：《齐鲁护理杂志》2015年第11期21-25,共5页Journal of Qilu Nursing

基　　金：遵义医学院博士启动基金资助项目(编号:F-617);贵州省哲学社会科学规划基金资助项目(编号:14GZYB58)

摘　　要：目的:系统评价我国新生儿呼吸机相关并发症特征及影响因素,为科学制订管理策略提供依据。方法:系统检索中国生物医学文献数据库(CBM)、中国学术期刊网络出版总库(CNKI)、维普中文科技期刊全文数据库(VIP)、万方数据库、Pubmed及Embase数据库中相关文献,采用NOS标准评价质量,定性及Meta分析提取数据。结果:Meta分析显示死亡患者的构成比在体重≤1.5 kg组高于﹥1.5 kg组,上机≥7 d组高于﹤7 d组(P<0.05);早产儿组呼吸机相关肺炎(VAP)、颅内出血、败血症、肺出血及气胸患者的构成比高于足月儿组(P<0.05);体重≤1.5 kg组并发VAP、败血症、肺出血、颅内出血及气胸患者的构成比高于﹥1.5 kg组(P<0.05)。上机≥7 d组并发VAP、败血症、颅内出血、肺出血及气胸患者构成比高于﹤7 d组(P<0.05)。结论:新生儿呼吸机相关并发症复杂多样,为患儿的重要死亡因素,研究证实VAP、败血症、肺出血、气胸及颅内出血等为重点监测指标;胎龄,低体重及上机时间均为呼吸机相关并发症的重要危险因素,其详细机制尚不清楚。Objective：To systematically evaluate ventilator- associated complications and the influencing factors in order to provide ba- sis for formulating scientific management strategies. Methods ： China biomedical literature database （ CBM ） , China national knowledge infra- structure （ CNKI ） , VIP, Wanfang database i Pubmed and Embase database were systematically retrieved i the quality and the data were eval- uated and analyzed by using NOS and qualitative and Meta - analysis. Results：The Meta - analysis showed that the constituent ratio of death cases was higher in those whose body weight was less than 1.5 kg than those more than 1.5 kg （ P 〈 0.05 ） ; the constituent ratio of the incidence of ventilator - associated pneumonia （ VAP ） , intracranial hemorrhage, sepsis, pulmonary hemorrhage and pneumothorax was higher in premature infants than that of full - term infants （ P 〈 0.05 ）. Conclusion ： The ventilator - associated complications in neonates are complex and diverse, and VAP, sepsis, pulmonary hemorrhage, pneumothorax and intracranial hemorrhage are the key monitoring indica- tors. The gestational age,low birth weight and duration of ventilation are the main risk factors of ventilator - associated complications.

关 键 词：呼吸机相关并发症 新生儿 呼吸机相关肺炎 机械通气 

分 类 号：R473.72[医药卫生—护理学]