重型颅脑损伤患者医院获得性肺部感染危险因素的Meta分析  

Meta analysis of the risk factors for hospital-acquired pulmonary infections in patients with traumatic brain injury

作　　者：宋凌霞[1] 张咏梅[1] 曾芬莲[1] 陈凌云[1] 

机构地区：[1]遵义医学院附属医院神经外科,贵州遵义563003

出　　处：《现代预防医学》2016年第8期1523-1526,共4页Modern Preventive Medicine

基　　金：遵义医学院附属医院硕士启动基金 院字号2015[23];贵州省科技合作计划项目 黔科合LH字[2015]7459号

摘　　要：目的探讨国内外有关重型颅脑损伤（TBI）患者医院获得性肺部感染的危险因素,为肺部感染预防策略的制定提供依据。方法计算机检索CNKI、万方、维普、Pub Med、Cochrane Libranry、EMBASE数据库,收集国内外发表的有关重型颅脑损伤患者肺部感染危险因素的病例对照研究。应用Rev Man5.3软件进行Meta分析,计算各影响因素OR值及95%CI。结果共纳入文献11篇,与肺部感染相关联的各危险因素合并OR值及95%CI分别为：年龄3.22（2.66-3.89）、气管切开2.51（2.12-2.96）、留置胃管6.90（5.51-8.66）、吸烟4.64（3.64-5.92）、合并基础病2.51（1.83-3.45）、机械通气3.10（2.28-4.23）、创伤性休克1.97（1.57-2.48）。结论年龄、气管切开、留置胃管、吸烟、合并基础病、机械通气、创伤性休克是重型颅脑损伤患者医院获得性肺部感染发生的主要危险因素。Objective The study aimed to explore the risk factors for hospital- acquired pulmonary infections in patients with traumatic brain injury（ TBI）,so as to provide a reference for the design of preventive strategies against pulmonary infections.Methods The domestic and international publications on case- control studies concerning the risk factors for pulmonary infection in TBI patients were retrieved from databases including CNKI,Wanfang,Cq Vip,Pub Med,Cochrane Libranry,and EMBASE. Meta analysis was conducted by Rev Man5. 3 to determine the OR values and 95% CIs of the influencing factors.Results A total of 11 literatures were included. The OR values and 95% CIs of the risk factors associated with pulmonary infection were age（ 3. 22; 2. 66- 3. 89）,tracheotomy（ 2. 51; 2. 12- 2. 96）,gastric intubation（ 6. 90; 5. 51- 8. 66）,smoking（ 4. 64; 3. 64- 5. 92）,combined underlying disease（ 2. 51; 1. 83- 3. 45）,mechanical ventilation（ 3. 10; 2. 28-4. 23）,and traumatic shock（ 1. 97; 1. 57- 2. 48）. Conclusion Age,tracheotomy,gastric intubation,smoking,combined underlying disease,mechanical ventilation,and traumatic shock are the main risk factors for hospital- acquired pulmonary infections in TBI patients.

关 键 词：重型颅脑损伤 肺部感染 危险因素 META分析 

分 类 号：R742[医药卫生—神经病学与精神病学]