ICU气管插管患者非计划拔管危险因素的Meta分析

目的明确ICU气管插管患者非计划拔管的危险因素。方法检索Web of Science、Embase、PubMed、中国知网、中国生物医学文献数据库、万方和维普等数据库2010年1月1日-2020年12月31日有关ICU气管插管非计划拔管危险因素的队列研究或病例对照研究，由两名研究人员独立进行文献筛选、资料提取以及文献质量评价。使用RevMan 5.3统计软件对纳入文献进行Meta分析。结果共纳入文献12篇,样本量为5 372例。Meta分析结果显示，年龄较小(WMD=-6.37)、男性(OR= 2.21)、镇静不足(OR=4.54)、RASS评分>-2分(OR=10.37)、Ramsay评级一二级(WMD=-1.05)、未使用身体约束(OR=5.35)、夜班(OR=3.31)、患有呼吸系统疾病和充血性心力衰竭(OR=2.34)、谵妄(OR=7.19)、更高的GCS评分(WMD=1.42)、心率过快（＞100次/分）(SMD=0.45)和机械通气时长(WMD=-2.31)等是ICU气管插管患者非计划拔管危险因素。结论通过Meta分析结果，可以构建ICU气管插管患者UEE风险预测模型，对患者进行危险因素分级，识别并管理高危患者，从而科学管理管路。

Risk Factors for Unplanned Extubation in ICU Patients with Endotracheal Intubation: A Meta-Analysis

ObjectiveTo identify risk factors of unplanned extubation in ICU patients with endotracheal intubation.MethodsWeb of Science, Embase, PubMed, CNKI, CBM,Wanfang VIP Data Knowledge Service Platform from January 1, 2010 to December 31, 2020 were searched. Case control and cohort studies on risk factors for unplanned extubation in ICU patients with endotracheal intubation were retrieved from the database. Literature screening, data extraction and quality evaluation were independently conducted by two researchers, and RevMan 5.3 software was used for Meta-analysis.ResultsA total of 12 literatures were included (5 372 ICU patients). The statistically significant risk factors were younger age (WMD= -6.37),male (OR=2.21),inadequate sedation (OR=4.54), RASS score > -2 (OR=10.37),Ramsay score 1 or 2 categories (WMD= -1.05),non-use of physical restraint (OR=5.35),night shift (OR=3.31),suffering from respiratory disease and congestive heart failure (OR=2.34),delirium (OR=7.19), higher GCS score (WMD=1.42),heart rate too fast (>100 beats/min) (SMD=0.45) and length of mechanical ventilation (WMD= -2.31).Conclusion Through the results of Meta-analysis, a UEE risk prediction model can be established for ICU patients with tracheal intubation, which can classify patients with risk factors, identify and manage high-risk patients, and manage the pipeline scientifically.