心脏外科术后病人呼吸机相关性肺炎危险因素的Meta分析  

Risk factors for ventilator-associated pneumonia in patients after cardiac surgery:a Meta-analysis

作　　者：吉双对 张竹英[2] 郑栋莲 郭淑萍[2] 白雪 刘风景 米光丽[1,2] JI Shuangdui;ZHANG Zhuying;ZHENG Donglian;GUO Shuping;BAI Xue;LIU Fengjing;MI Guangli(School of Nursing,Ningxia Medical University,Ningxia 750004)

机构地区：[1]宁夏医科大学护理学院,宁夏750004 [2]宁夏医科大学总医院

出　　处：《循证护理》2023年第13期2295-2300,共6页Chinese Evidence-Based Nursing

基　　金：2022年宁夏回族自治区重点研发计划项目,编号:2022BEG03095;宁夏医科大学科学研究基金资助项目,编号:XM2022048。

摘　　要：目的:通过Meta分析综合评价心脏外科术后病人呼吸机相关性肺炎(VAP)的危险因素,为临床预防VAP提供参考依据。方法:计算机检索Web of Science、PubMed、EMbase、中国知网、中国生物医学文献数据库、万方数据库、维普数据库中关于心脏外科术后病人VAP危险因素的病例对照研究和队列研究,检索时限为建库至2022年8月30日。由2名评价者按纳入与排除标准对所获文献进行独立筛选、资料提取和方法学质量评价,应用RevMan 5.3进行Meta分析。结果:纳入11篇文献,共4561例病人。Meta分析结果显示,体外循环时间≥120 min、输血量>1200 mL、术后氧合指数≤300 mmHg、气管切开、机械通气时间≥5 d、再次插管、应用抑酸剂、二次开胸、肺动脉高压是成人心脏术后病人VAP的独立危险因素。结论:临床医护人员应根据成人心脏术后VAP的危险因素采取针对性的预防措施,从而有效降低病人术后VAP的发生率。Objective:To comprehensively evaluate ventilator-associated pneumonia(VAP)risk factors in patients after cardiac surgery through meta-analysis and provide a reference for clinical prevention of VAP.Methods:Case-control studies and cohort studies on risk factors for VAP in patients after cardiac surgery were retrieved from Web of Science,PubMed,EMbase,China National Knowledge Infrastructure(CNKI),China Biomedical Literature Database,WanFang Database,and VIP from the establishment of the database until August 30,2022.According to the inclusion and exclusion criteria,2 evaluators independently screened the obtained literature,extracted data,and evaluated the methodological quality.RevMan 5.3 was used for Meta-analysis.Results:A total of 11 articles were included,with a total of 4561 patients.Meta-analysis results showed that extracorporeal circulation time≥120 min,blood transfusion>1200 mL,postoperative oxygenation index≤300 mmHg,tracheotomy,mechanical ventilation time≥5 days,reintubation,application of antacids,secondary thoracotomy,and pulmonary hypertension were independent risk factors for VAP in adult patients after cardiac surgery.Conclusion:Clinical medical staff should take targeted preventive measures according to the risk factors of VAP after cardiac surgery in adults to effectively reduce the incidence of VAP in patients after surgery.

关 键 词：心脏外科手术 成人 呼吸机相关性肺炎 危险因素 META分析 循证护理 

分 类 号：R473.6[医药卫生—护理学]