术中急性压力性损伤发生危险因素的Meta分析  

Risk factors of intraoperative acute stress injury:a Meta-analysis

作　　者：靳苗苗[1] 何学元[2] 田金徽[3] 张志刚[4] 陶贵彦[1] JIN Miaomiao;HE Xueyuan;TIAN Jinhui;ZHANG Zhigang;TAO Guiyan(Lanzhou University First Hospital,Gansu 730000 China)

机构地区：[1]兰州大学第一医院,甘肃730000 [2]甘肃省人民医院 [3]兰州大学循证医学中心 [4]兰州大学重症监护室

出　　处：《循证护理》2022年第16期2142-2149,共8页Chinese Evidence-Based Nursing

摘　　要：目的:探讨术中急性压力性损伤发生的危险因素。方法:检索the Cochrane Library、PubMed、EMbase、Web of Science、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据期库(WanFang Data)及学位论文数据库等,检索时间截至2019年4月23日,补充其他途径获取的相关临床对照试验及队列研究,按预先制定的纳入与排除标准筛选和纳入,并对纳入的研究的质量进行评价,数据采用StateSE 12软件进行数据分析。结果:共纳入22项研究,涉及15864例病人。Meta分析结果显示:术中急性压力性损伤发生的危险因素分别为体质指数[WMD=1.22,95%CI(0.05,2.40),P<0.001]、年龄[WMD=3.40,95%CI(2.53,4.26),P<0.001]、手术时间[WMD=75.69,95%CI(66.70,84.69),P<0.001]、糖尿病[WMD=2.51,95%CI(1.39,4.52),P<0.001]、血红蛋白[WMD=-11.16,95%CI(-14.34,-7.99),P<0.001]和血清总蛋白[WMD=-3.48,95%CI(-3.92,-3.03),P<0.001]。结论:现有证据表明,BMI越高、高龄、手术时间长、糖尿病、低血红蛋白、低血清总蛋白水平是术中急性压力性损伤发生的危险因素。Objective:To explore the risk factors of acute intraoperative stress injury.Methods:The Cochrane Library,PubMed,EMbase,Web of Science,CBM,CNKI,Wanfang DataBASE,dissertation database,etc were searched.The retrieval time was from inception to April 23,2019.Supplemented relevant clinical controlled trials and cohort studies obtained from other ways,screened according to the pre-determined inclusion and exclusion criteria,and evaluated the quality of the included studies.The data were analyzed by StateSE 12 software.Results:A total of 22 studies were included,involving 15864 patients.Meta-analysis results showed that the risk factors of acute intraoperative stress injury were BMI[WMD=1.22,95%CI(0.05,2.40),P<0.001],age[WMD=3.40,95%CI(2.53,4.26),P<0.001],operation time[WMD=75.69,95%CI(66.70,84.69),P<0.001],diabetes[WMD=2.51,95%CI(1.39,4.52),P<0.001],hemoglobin[WMD=-11.16,95%CI(-14.34,-7.99),P<0.001],serum total protein[WMD=-3.48,95%CI(-3.92,-3.03),P<0.001].Conclusion:Current evidence shows that BMI,advanced age,long operation time,diabetes,low hemoglobin,low serum total protein are the risk factors for acute intraoperative stress injury.

关 键 词：急性压力性损伤 手术 危险因素 META分析 循证护理 

分 类 号：R473.6[医药卫生—护理学]