新生儿呼吸机相关性肺炎高危机械通气因素的Meta分析  

Meta analysis of high risk factors of VAP in neonates

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

机构地区：[1]遵义医学院附属医院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21期10-15,共6页Journal of Qilu Nursing

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

摘　　要：目的:系统分析新生儿VAP相关高危机械通气因素,为科学制订新生儿VAP的预警及预防策略提供依据。方法:计算机及手工检索CBM、CNKI、万方、ISI、Pubmed及Embase数据库中相关文献,采用NOS标准评价纳入研究偏倚风险、定性及Meta分析定量结合分析研究数据。结果:纳入20个病例对照研究,NICU新生儿3 497例,VAP 1 173例,3类机械通气相关因素。Meta分析结果显示:再次插管、平均插管次数、反复吸痰、吸痰≥8次/d、平均通气时间、通气>7 d、通气≥4 d和通气<4 d指标差异有统计学意义(P<0.01)。结论:本研究证实再次插管、反复吸痰及通气时间延长增加VAP风险,均为新生儿VAP重要高危因素及预警指标,但尚需深入研究揭示吸痰次数及通气时间与VAP风险的动态关系。Objective：To systematically analyze the high risk factors of ventilator - associated pneumonia（VAP）in neonates in order to provide the basis for the scientific development of the early warning and prevention strategy of VAP. Methods：We retrieved all studies about the ventilation - related factors of VAP in neonates in CNKI,Wanfang,CBM,ISI,Pubmed and Embase and evaluated their risk of bias by Newcastle - Ottawa scale and analyzed all data by qualitative and meta - analysis. Results：20 cases were included in the control study,in-volving 3497 neonates in NICU（1173 cases of VAP）and 3 types of mechanical ventilation related factors. The results of meta - analysis showed that significant differences were found in reintubation,average intubation times,repeated suctioning,suctioning≥8times/ d,average ventilator time,the duration of ventilation ﹥ 7d,ventilation≥4d and ventilation ﹤ 4d（P ﹤ 0. 01）. Conclusion：This study confirms that the reintubation and repeated suctioning can increase the risk of VAP and they are the important risk factors and early warning index. Further research is needed to reveal the dynamic relationship between sputum suction times or ventilation time and the VAP risk.

关 键 词：新生儿 呼吸机相关肺炎 机械通气 高危因素 

分 类 号：R473.72[医药卫生—护理学]