ICU病人医疗器械相关性压力性损伤发生率及影响因素的Meta分析  

Incidence and influencing factors of medical device-related pressure injury in ICU patients:a Meta-analysis

作　　者：彭婉琳 陈德凤[2] 李蓓 董旭辉 陈玉崟 PENG Wanlin;CHEN Defeng;LI Bei;DONG Xuhui;CHEN Yuyin(School of Nursing,Guangxi University of Chinese Medicine,Guangxi 530004 China)

机构地区：[1]广西中医药大学护理学院,广西530004 [2]广西壮族自治区人民医院(广西医学科学院)

出　　处：《循证护理》2023年第22期4012-4018,共7页Chinese Evidence-Based Nursing

摘　　要：目的:系统评价重症监护室(ICU)病人医疗器械相关性压力性损伤发生率及其影响因素。方法:计算机检索PubMed、EMbase、the Cochrane Library、Web of Science、中国知网(CNKI)、万方数据库(WanFang Database)、维普数据库(VIP)、中国生物医学文献数据库(CBM)已发表的相关文献,检索时限从建库至2022年12月28日。由2名研究人员独立筛选文献、提取数据并评估文献质量。采用Stata 17.0软件和RevMan 5.4软件对发生率及影响因素进行Meta分析。结果:共纳入13篇文献,涉及8168例病人。Meta分析结果显示,ICU病人医疗器械相关性压力性损伤发生率为21%,影响ICU病人医疗器械相关性压力性损伤发生的因素包括:急性生理及慢性健康状况(APACHEⅡ)评分[OR=1.31,95%CI(1.10,1.57),P=0.003]、俯卧位通气[OR=17.75,95%CI(7.22,43.61),P<0.00001]、Braden评分[OR=0.47,95%CI(0.23,0.95),P=0.03]、手术[OR=7.48,95%CI(2.38,23.55),P=0.0006]、水肿[OR=3.62,95%CI(2.31,5.67),P<0.001]。结论:现有证据表明,APACHEⅡ评分、俯卧位通气、Braden评分、手术、水肿是ICU病人发生医疗器械相关性压力性损伤的影响因素。应针对这些影响因素进行早期预防和管理,以改善病人的生活质量并减少不良结局对病人的影响。Objective:To systematically evaluate the incidence and influencing factors of medical device-related stress injuries in intensive care unit(ICU)patients.Method:Relevant literature was retrieved from PubMed,EMbase,the Cochrane Library,Web of Science,CNKI,WanFang Database,VIP,and CBM.The search period was from the establishment of the database to December 28,2022.Two researchers independently screened the literature,extracted data and assessed the quality of the literature.Meta analysis was conducted on the incidence and influencing factors using Stata 17.0 software and RevMan 5.4 software.Result:A total of 13 articles were included,involving 8168 patients.The Meta-analysis results showed that the incidence of medical device related pressure injury in ICU patients was 21%.Factors affecting the occurrence of medical device related pressure injury in ICU patients included:APACHEⅡscore(OR=1.31,95%CI 1.10-1.57,P=0.003),prone position ventilation(OR=17.75,95%CI 7.22-43.61,P<0.00001),Braden score(OR=0.47,95%CI 0.23-0.95,P=0.03),surgery(OR=7.48,95%CI 2.38-23.55,P=0.0006),edema(OR=3.62,95%CI 2.31-5.67,P<0.001)。Conclusion:Existing evidence suggests that APACHEⅡscore,prone position ventilation,Braden score,surgery,and edema are influencing factors for the occurrence of medical device-related pressure injury in ICU patients.Early prevention and management should be targeted at these influencing factors to improve patients′quality of life and reduce the impact of adverse outcomes on patients.

关 键 词：重症监护室 医疗器械相关性压力性损伤 影响因素 META分析 循证护理 

分 类 号：R473[医药卫生—护理学]