神经外科重症监护室呼吸机相关性肺炎危险因素的Meta分析

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摘要目的系统评价神经外科ICU中呼吸机相关性肺炎(VAP)的危险因素。方法计算机检索建库至2024-06期间CNKI、VIP、万方数据库、PubMed、Embase、The Cochrane library、CBM和Web of Science等中英文数据库中的相关文献,使用RevMan5.4和stata15.0进行Meta分析。结果纳入文献11篇,包括中文文献9篇,英文文献2篇,纳入研究对象2022例,对16个可能的危险因素进行综合评价。吸烟、昏迷、APACHEⅡ评分、血清白蛋白<30 g/L、抗生素使用时间>3 d、糖皮质激素使用、镇静剂使用、亚低温治疗、机械通气时间≥5 d、ICU住院时间长10项因素是神经外科ICU发生VAP的危险因素(P＜0.05),早期抗生素使用可降低其VAP的发生(P＜0.05)。结论临床医护人员应密切关注上述危险因素,早期识别并采取有效的防控措施,减少神经外科ICU内VAP的发生。

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	林伟
	石陈燕
	赵祝英
	鞠子涵
	赵芳珉

关键词 ：神经外科, 重症监护, 呼吸机相关性肺炎, 危险因素, Meta分析

Abstract：Objective To systematic evaluate the risk factors for ventilator-associated pneumonia (VAP) in neurosurgery ICU. Methods Relevant literatures in CNKI, VIP, Wanfang, PubMed, Embase, The Cochrane library, CBM, Web of Science and other Chinese and English databases were searched by computer until June 2024. Meta-analysis was performed using RevMan5.4 and stata15.0. Results A total of 11 literatures were included, including 9 Chinese ones and 2 English ones, 2022 subjects were included in the study, and 16 possible risk factors were comprehensively evaluated. Smoking, coma, APACHE Ⅱ score, serum albumin <30 g/L, antibiotic use time >3 d, glucocorticoid use, sedative use, hypothermia treatment, mechanical ventilation time≥5 d, and long ICU stay were the risk factors for VAP in neurosurgery ICU (P＜0.05). Early use of antibiotics could reduce the occurrence of VAP (P＜0.05). Conclusions In order to identify and take effective prevention and control measures in the early stage to reduce the occurrence of VAP in neurosurgery ICU, clinical staff should closely monitor the above mentioned risk factors.

Key words： neurosurgery intensive care ventilator associated pneumonia risk factors meta-analysis

收稿日期: 2024-11-12

ZTFLH:

R473

基金资助:军队某课题资助

通讯作者: 赵芳珉,E-mail:jkk426@126.com

作者简介: 林伟,本科学历,医师。

引用本文:

林伟, 石陈燕, 赵祝英, 鞠子涵, 赵芳珉. 神经外科重症监护室呼吸机相关性肺炎危险因素的Meta分析[J]. 武警医学, 2025, 36(4): 290-294. LIN Wei, SHI Chenyan, ZHAO Zhuying, JU Zihan, ZHAO Fangmin. Meta-analysis of risk factors for ventilator-associated pneumonia in intensive care units of neurosurgery. Med. J. Chin. Peop. Armed Poli. Forc., 2025, 36(4): 290-294.

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https://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 https://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2025/V36/I4/290

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