中国肺结核患者医院感染危险因素的Meta分析  

Meta-analysis on risk factors for nosocomial infection in Chinese patients with pulmonary tuberculosis

作　　者：刘亚兰 谢娟 邓兵 李佩林 李同心[1] 孙庆云[1] 苏世芳 黄娅玲 LIU Yalan;XIE Juan;DENG Bing;LI Peilin;LI Tongxin;SUN Qingyun;SU Shifang;HUANG Yaling(Chongqing Public Health Medical Center,Chongqing 400036,China)

机构地区：[1]重庆市公共卫生医疗救治中心(疾病预防控制与公共卫生研究中心),400036

出　　处：《首都公共卫生》2024年第4期248-255,共8页Capital Journal of Public Health

基　　金：2024年重庆市科卫联合医学科研项目(编号:2024MSXM061);重庆市沙坪坝区2024年技术创新项目(编号:2024058)。

摘　　要：目的系统分析并评价中国肺结核患者发生医院感染的危险因素,为防控肺结核患者发生医院感染提供证据。方法检索中国知网、万方医学网、维普和PubMed等数据库,收集各库2001年1月1日—2023年6月30日发表的有关肺结核患者发生医院感染危险因素的研究,文献筛选、数据提取和质量评价由2名研究者根据纳入排除标准独立完成,采用RevMan 5.3和Stata14.0软件进行Meta分析。结果最终纳入文献15篇,11744例肺结核患者发生医院感染1175例,在纳入的13项研究因素中,11项有统计学意义(P均<0.05),包括年龄≥60岁(OR=2.673)、吸烟史(OR=2.063)、肺结核复治(OR=2.198)、基础疾病(OR=2.731)、糖尿病(OR=2.178)、白蛋白水平>40 g/L(OR=2.506)、住院时间≥30 d(OR=6.476)、住院前抗生素>2周(OR=4.440)、抗生素使用时间>7 d(OR=2.076)、抗生素使用>2种(OR=2.670)和侵入性操作(OR=4.815)。结论肺结核临床诊疗应及时识别高危人群,有效治疗基础疾病提高免疫力,规范抗菌药物的合理使用,严格把握侵入性操作指针,有效降低医院感染风险。Objective To systematically evaluate the risk factors of nosocomial infection in patients with pulmonary tuberculosis,providing evidence for the prevention and control of nosocomial infection.Methods The databases of CNKI,Wan fang,VIP and PubMed were searched to collect studies on the risk factors for nosocomial infections among pulmonary tuberculosis patients,published from January 1,2001 to June 30,2023.Two researchers independently screened literature,extracted data and evaluated the quality according to the inclusion and exclusion criteria.Rev Man 5.3 and Stata14.0 software meta-analysis were used for meta-analysis.Results A total of 15 papers were included from the retrieved literature,involving 11744 pulmonary tuberculosis patients,of whom 1175 got nosocomial infection.Of the 13 included study factors,11 showed statistically significant differences including age≥60 years(OR=2.673),smoking(OR=2.063),retreated pulmonary tuberculosis(OR=2.198),underlying diseases(OR=2.731),diabetes mellitus(OR=2.178),albumin level(OR=2.506),length of hospital stay≥30 days(OR=6.476),pre-hospital antibiotics use more than two weeks(OR=4.440),antibiotics use more than 7 days(OR=2.076),antibiotic use more than 2 types(OR=2.670)and invasive operation(OR=4.815).Conclusions Clinical diagnosis and treatment of tuberculosis should promptly identify high-risk groups,effectively manage underlying diseases and enhance immunity,regulate the rational use of antibiotics,and strictly adhere to guidelines for invasive procedures to effectively reduce the risk of nosocomial infections.

关 键 词：肺结核 医院感染 META分析 危险因素 

分 类 号：R521[医药卫生—内科学]