重症监护病房血流感染危险因素的Meta分析  

Meta-analysis of risk factors for bloodstream infections in intensive care unit

作　　者：齐志丽[1] 林瑾[1] 董磊[1] 刘景峰[1] 段美丽[1] Qi Zhili;Lin Jin;Dong Lei;Liu Jingfeng;Duan Meili(Department of Intensive Care Unit,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院重症医学科,北京100050

出　　处：《首都医科大学学报》2021年第6期923-930,共8页Journal of Capital Medical University

基　　金：北京市临床重点专科建设项目卓越项目(京卫医[2020]129号)。

摘　　要：目的探讨重症监护病房(intensive care unit,ICU)患者发生血流感染(blood stream infection,BSI)的危险因素。方法在英文数据库Cochrane Library、PubMed、Embase、Web of Science及中文数据库CBM、中国知网、万方、维普检索关于BSI危险因素的相关文献,检索时间为从各数据库建库至2021年4月,通过双人交叉纳入、排除、提取最终获得文献的效应量,使用Revman 5.0进行数据分析,评估了研究异质性和偏倚风险。结果获得参考文献13691篇,经过纳入、排除后最终获得符合要求的文献11篇,采用(Newcastle-Ottawa Scale,NOS)量表对纳入研究的方法学质量进行评分,最终结果显示危重症患者发生BSI的危险因素有以下8项:肠外营养(OR=5.07,95%CI:2.89~9.10)、呼吸衰竭(OR=3.03,95%CI:1.90~4.83)、脓毒症(OR=2.13,95%CI:1.50~3.01)、深静脉置管(OR=3.57,95%CI:2.16~5.90)、免疫抑制(OR=3.52,95%CI:1.72~7.20)、机械通气(OR=5.28,95%CI:2.05~13.62)、心脏事件(OR=3.07,95%CI:1.68~5.62)、既往暴露于抗生素(OR=2.46,95%CI:1.14~5.33)。结论初步阐明重症监护病房患者发生BSI的危险因素包括肠外营养、呼吸衰竭、脓毒症、深静脉置管、免疫抑制、机械通气、心脏事件、既往暴露于抗生素。Objective To investigate the risk factors of bloodstream infections(BSI)in intensive care unit(ICU).Methods We screened the studies in English databases(Cochrane Library,PubMed,Embase,Web of Science)and Chinese databases(CBM,CNKI,Wanfang,Weipu)from each starting year to April 2021.Two investigators independently reviewed the articles and extracted the information according to the established inclusion and exclusion criteria,and cross-checked.Data analysis was performed by the software RevMan5,and the heterogeneity among the study and risk of bias were also evaluated.Results Among the initial identified 13691 articles,11 studies were brought into study.Our results showed that risk factors of BSI are parenteral nutrition(OR=5.07,95%CI:2.89-9.10),respiratory failure(OR=3.03,95%CI:1.90-4.83),sepsis(OR=2.13,95%CI:1.50-3.01),central venous catheterization(OR=3.57,95%CI:2.16-5.90),immunosuppression(OR=3.52,95%CI:1.72-7.20),mechanical ventilation(OR=5.28,95%CI:2.05-13.62),cardiovascular events(OR=3.07,95%CI:1.68-5.62),and previous antibiotic exposure(OR=2.46,95%CI:1.14-5.33).Conclusion The risk factors of BSI in the ICU included parenteral nutrition,respiratory failure,sepsis,central venous catheterization,immunosuppression,mechanical ventilation,cardiovascular events,and previous antibiotic exposure.

关 键 词：血流感染 危险因素 重症监护病房 

分 类 号：R195.4[医药卫生—卫生统计学]