起搏器植入术后患者囊袋感染危险因素的Meta分析  

Risk factors for pacemaker pocket infection:A meta analysis

作　　者：蔡丽梅[1] 舒玲玲[2] 陈洁珊[1] 任敏陶[1] CAI Li-mei;SHU Ling-ling;CHEN Jie-shan;REN Min-tao(Department of Cardiovascular Medicine,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China;Department of Cardiovascular Medicine,The Third Affiliated Hospital of Sun Yat sen University,Guangzhou 510630,China)

机构地区：[1]广州医科大学附属第一医院心血管内科,广州510120 [2]中山大学附属第三医院心血管内科,广州510630

出　　处：《岭南心血管病杂志》2022年第3期246-250,268,共6页South China Journal of Cardiovascular Diseases

摘　　要：目的系统评价起搏器植入术后囊袋感染的危险因素,为预防起搏器囊袋感染提供科学依据。方法计算机检索CNKI、万方、CBM、VIP、Cochrane Library、PubMed、Web of Science、Embase数据库,文献发表时间为建库至2020年11月31日,检索词包括英文检索词:“Pacemaker/Cardiac Resynchronization Therapy Devices”、“infections”、“relative/risk*/relative risk/risks”、“Cohort Studies/Cohort/stud*”;中文检索词:“心脏起搏器/起搏器”、“感染”、“危险因素/影响因素/病因/相关因素”、“病例对照研究/病例对照/队列研究”。根据纳入和排除标准,并将文献质量评价得分≥7分的文献纳入研究,meta分析采用RevMan 5.3软件。结果共纳入11篇文献,包括12108例起搏器植入患者。Meta分析结果显示,起搏器更换或升级[OR=2.68,95%CI:1.46~4.9,P<0.01]、手术时间[OR=3.26,95%CI:2.36~4.52,P<0.01]、囊袋血肿[OR=2.19,95%CI:1.57~3.04,P<0.01]、年龄[OR=2.54,95%CI:1.61~4.03,P<0.01]、抗凝治疗[OR=3.63,95%CI:1.75~7.57,P<0.01]、糖尿病[OR=3.83,95%CI:2.36~6.21,P<0.01]、起搏器类型[OR=6.62,95%CI:2.81~15.63,P<0.01]、心力衰竭[OR=3.06,95%CI:1.79~5.24,P<0.01]、切口脂肪液化[OR=2.36,95%CI:1.65~3.39,P<0.01]、男性[OR=4.57,95%CI:2.52~8.28,P<0.01]、手术次数≥2次[OR=1.97,95%CI:1.35~2.88,P<0.01]是起搏器囊袋感染发生的危险因素。结论起搏器更换或升级、手术时间、囊袋血肿、年龄、抗凝治疗、糖尿病、起搏器类型、心力衰竭、切口脂肪液化、男性、手术次数≥2次是起搏器囊袋感染发生的独立危险因素。Objectives To analyze the risk factors for the pocket infection following implantation of pacemaker by meta-analysis and provide a scientific reference for its prevention.Methods The inclusion and exclusion criteria were determined and the search strategies were designed.Two researchers independently searched both English and Chinese databases such as CNKI,CBM,Wanfang,VIP,Cochrane Library,PubMed,Web of Science,Embase(taking"pacemaker/cardiac resynchronization therapy devices","infections","relative/risk*/relative risk/risks","cohort studies/cohort/stud*"as the key words or free words)for literatures published since the databases were built to November 31 st,2020.According to the inclusion and exclusion criteria,and using the evaluation criteria of the Newcastle-Ottawa Scale(NOS),the quality evaluation of the extracted literature was carried out.The literature with a score of 7 or more was included in the study.RevMan 5.3 was used to analyze the data.Results Totally 11 articles were included,including 12108 patients with pacemaker implantation.Meta-analysis showed that pacemaker replacement or upgrading[OR=2.68,95%CI:1.46-4.90,P<0.01],operative duration[OR=3.26,95%CI:2.36-4.52,P<0.01],pocket hematoma[OR=2.19,95%CI:1.57-3.04,P<0.01],age[OR=2.54,95%CI:1.61-4.03,P<0.01],anticoagulant therapy[OR=3.63,95%CI:1.75-7.57,P<0.01],diabetes[OR=3.83,95%CI:2.36-6.21,P<0.01],pacemaker type[OR=6.62,95%CI:2.81-15.63,P<0.01],heart failure[OR=3.06,95%CI:1.79-5.24,P<0.01],incision fat liquefaction[OR=2.36,95%CI:1.65-3.39.P<0.01],male[OR=4.57,95%CI:2.52-8.28,P<0.01],times of operation≥2[OR=1.97,95%CI:1.35-2.88,P<0.01]were the influencing factors for pacemaker pocket infection.Conclusions Pacemaker replacement or upgrading,operative duration,pocket hematoma,age,anticoagulant therapy,diabetes,pacemaker type,heart failure,incision fat liquefaction,male,times of operation≥2 were independent risk factors for pacemaker pocket infection.

关 键 词：起搏器 感染 危险因素 META分析 

分 类 号：R541.7[医药卫生—心血管疾病]