ICU患儿谵妄危险因素的Meta分析  

Risk factors of delirium in pediatric ICU:a Meta-analysis

作　　者：徐婷婷[1,2] 张伟英[3] 叶小飞[4] 周如女[3] 杨晓亚[1] XU Tingting;ZHANG Weiying;YE Xiaofei;ZHOU Runyu;YANG Xiaoya(Intensive Care Unit,Shanghai Children's Hospital,Shanghai Jiao Tong University,Shanghai,200062,China)

机构地区：[1]上海交通大学附属儿童医院重症医学科,上海市200062 [2]同济大学医学院 [3]同济大学附属东方医院护理部 [4]海军军医大学卫生统计学教研室

出　　处：《中国护理管理》2021年第3期387-392,共6页Chinese Nursing Management

基　　金：上海医药基金会青年护理人才培养项目(2018);上海交通大学高原学科建设青年后备人才项目(hlgy1908qnhb)。

摘　　要：目的:分析ICU患儿发生谵妄的危险因素,为临床早期预防ICU患儿谵妄的发生提供参考依据。方法:计算机检索PubMed、Web of Science、Cochrane Library、Embase、中国生物医学文献数据库、中国知网、维普数据库及万方数据库,收集关于ICU患儿发生谵妄危险因素的文献,检索时限为从建库至2020年7月10日。由2名评价人员按照标准独立进行文献筛选、资料提取和质量评价后,采用Stats 14.0软件进行Meta分析。结果:共纳入7篇文献,包括3398例研究对象,病例组808例,对照组2590例,共26项危险因素。Meta分析显示,发育迟缓、机械通气、苯二氮卓类药物及年龄是ICU患儿发生谵妄的重要危险因素。结论:基于现有证据,发育迟缓、机械通气以及使用苯二氮卓类药物的ICU患儿发生谵妄的可能性较大,且谵妄的发生风险与年龄呈反比,年龄越小发生谵妄的风险也就越高。目前关于ICU患儿谵妄危险因素的研究证据尚不充足,且各研究样本量、使用的评估工具及评估频次也存在较大差异,后期尚需要更多高质量的研究进行验证。Objective:To systematically analyze the risk factors of delirium observed in pediatric ICU so as to provide clinical evidences and guidance for early prevention of such situations.Methods:Studies regarding risk factors of delirium observed in children during their stay in ICU were retrieved and collected from various databases including PubMed,Web of Science,Cochrane Library,Embase,CBMWEB,CNKI,VIP Database and WanFang Database since the time of their construction till July 10,2020.Two staff were appointed to do the work independently of literature screening,data extracting and quality evaluation in accordance with the criteria.Then all the data were Meta-analyzed through Stats 14.0.Results:In the end 7 papers were included in the study containing 3398 objects in total with 808 cases in the experiment group and 2590 cases in the control group.And 26 risk factors were extracted at last.Meta-analysis showed that developmental retardation,mechanical ventilation,Benzodiazepines and age were major risk factors causing delirium in children admitted to ICU.Conclusion:Based on the existing evidences,children with developmental retardation,receiving mechanical ventilation and Benzodiazepines are more liable to have delirium in ICU.Since the relationship between occurrence of delirium and age is negative,younger patients tend to have higher risks of delirium.The evidences about risk factors of delirium in pediatric ICU patients at present are far from sufficiency with discrepancies of research samples,assessing tools and frequency of assessment among different studies.Thus more quality studies will be needed for further validation.

关 键 词：谵妄 重症监护病房 危险因素 儿童 META分析 

分 类 号：R47[医药卫生—护理学]