中心静脉导管相关性感染的Meta分析  

Meta analysis of central venous catheter-related infections

作　　者：张耀华[1] 曾凤飞[1] 余强[1] 张明铭[1] ZHANG Yaohua;ZENG Fengfei;YU Qiang;ZHANG Mingming(Department of Neurosurgery,The Second Xiangya Hospital of Central South University,Changsha,Hu'nan,430011,China)

机构地区：[1]中南大学湘雅二医院神经外科,湖南长沙430011

出　　处：《当代医学》2024年第24期1-7,共7页Contemporary Medicine

基　　金：湖南省卫生厅科技计划项目(202300056)。

摘　　要：目的采用Meta分析中心静脉导管(central venous catheter,CVC)相关性感染的影响因素,为预防感染提供参考。方法使用计算机查询中国知识基础设施工程(知网)、万方数据知识平台服务(万方)、中文科技期刊数据库(维普)、中国生物医学文献数据库(China Biol‐ogy Medicine disc,CBMdisc)、PubMed、Embase数据库检索应用CVC与感染相关性的病例对照研究,检索时间从建库至2022年12月,中文检索词为“中心静脉导管”“重症室”“感染”“神经外科”“病例对照试验”“队列研究”,英文检索词为“Central Venous Catheter”“Intensive Care Unit”“Infection”“Neurosurgery”“Case-Control Trial”“Cohort Study”。应用RevMan 5.3对文献进行Meta分析。结果共检索482篇文献,最终纳入15篇文献,其中患者CVC置管11880例次。Meta分析结果显示:年龄≥60岁[OR=3.20,95%CI(2.67,3.83),P<0.00001],导管留置时间>6 d[OR=17.66,95%CI(9.68,32.22),P<0.00001],有高血压、糖尿病、心脑血管疾病等基础病[OR=44.69,95%CI(27.96,71.43),P<0.00001],急性生理学与慢性健康状况评估系统(acute physiology and chronic health evaluation,APACHE)Ⅱ评分≥20分[OR=14.68,95%CI(9.69,22.24),P<0.00001],免疫功能低下[OR=2.5,95%CI(2.01,3.11),P<0.00001],输注静脉营养液[OR=14.68,95%CI(9.69,22.24),P<0.00001],置管者年资<5年[OR=2.27,95%CI(1.72,3.00),P<0.00001],使用多腔导管[OR=4.06,95%CI(2.81,5.86),P<0.00001]是CVC相关性感染发生的危险因素。结论年龄、导管留置时间、基础病因素、APACHEⅡ评分、免疫功能、静脉营养、置管者年资及多腔导管是CVC相关感染发生的影响因素,临床应高度警惕上述因素,制定相应的预防措施,改善患者预后。Objective To conduct a Meta-analysis on the influencing factors of central venous catheter(CVC)-related infections,in order to provide reference for preventing the occurrence of infections.Methods The Chinese National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Platform Service(Wanfang),Chinese Science and Technology Journal Database(VIP),China Biology Medicine disc(CBMdisc),PubMed,Embase Database were searched using computers for case-control studies on the association between CVC and infection were searched from the establishment of the database to December 2022.The Chinese search terms were Central Venous Catheter,Intensive Care Unit,Infection,Neurosurgery,Case-Control Trials,and Cohort Study,and the English search terms were Central Venous Catheter,Intensive Care Unit,"Infection,Neurosurgery,Case-Control Trials,and Cohort Study.Meta analysis of literature was conducted using RevMan 5.3.Results A total of 482 articles were retrieved,and 15 articles were ultimately included,including 11880 cases of CVC placement in patients.Meta analysis results showed that:age≥60 years old[OR=3.20,95%CI(2.67,3.83),P<0.00001],catheter retention time>6 d[OR=17.66,95%CI(9.68,32.22),P<0.00001],hypertension,diabetes,cardiovascular and cerebrovascular diseases and other basic disease factors[OR=44.69,95%CI(27.96,71.43),P<0.00001],APACHEⅡscore≥20 scores[OR=14.68,95%CI(9.69,22.24),P<0.00001],low immune function[OR=2.5,95%CI(2.01,3.11),P<0.00001],intravenous nutrient solution infusion[OR=14.68,95%CI(9.69,22.24),P<0.00001],seniority of intubation<5 years[OR=2.27,95%CI(1.72,3.00),P<0.00001],use of multi lumen catheter[OR=4.06,95%CI(2.81,5.86),P<0.00001]were risk factors for CVC-related infection.Conclusion Age,indwelling time of catheter,hypertension,diabetes,cardiovascular and cerebrovascular diseases and other basic disease factors,APACHEⅡscore,immune function,intravenous nutrition,seniority of catheters and multi lumen catheter are the influencing factors of CVC-related infection,clinicians should be highly alert to

关 键 词：中心静脉导管 感染 神经外科 重症监护室 

分 类 号：R47[医药卫生—护理学]