我国呼吸机相关性肺炎发病危险因素的Meta分析

目的:综合评价国内呼吸机相关性肺炎(ventilator associated pneumonia,VAP)发病的危险因素?方法:通过国内外数据库检索中国发表的VAP危险因素的相关研究,用Meta分析的方法对入选文献进行定量综合分析;用固定效应模型或随机效应模型计算OR值及95%CI?结果:总共14篇相关文献入选本研究,累计病例691例,对照病例1 145例;在分析的9个危险因素中有5个因素差异具有统计学意义,与VAP相关的危险因素及其OR值分别为:预防性抗菌药物使用(OR=6.60,95%CI:3.01~14.50)?气管切开(OR=4.25,95%CI:2.32~7.76)?鼻胃管留置(OR=3.09,95%CI:1.85~5.16)?胃肠内营养(OR=3.44,95%CI:1.22~9.68)?糖皮质激素应用(OR=3.28,95%CI:1.68~6.38)?结论:应针对国内VAP发病相关的危险因素采取针对性预防措施,从而降低VAP的发生率?

Risk factors of ventilator associated pneumonia:a Meta-analysis in China

Objective:To synthetically evaluate the risk factors of ventilator associated pneumonia (VAP) in China. Methods:The relative researches of VPA were searched by domestic and abroad literature database,and literatures published in China selected were quantitatively analyzed by Meta-analysis. The pooled OR and its corresponding 95%CI were calculated by fixed effect model or random effect model. Results:Fourteen relative literatures were selected in this study,including 691 patients and 1 145 controls. Among nine risk factors,five factors had statistical significances. Risk factors of VAP and its value of OR were as follows:prophylactic antibiotic use (OR=6.60,95%CI:3.01~14.50),tracheostomy(OR=4.25,95%CI:2.32~7.76),nasal and gastric tube (OR=3.09,95%CI:1.85~5.16),enteral nutrition(OR=3.44,95%CI:1.22~9.68),glucocorticoid use(OR=3.28,95%CI:1.68~6.38). Conclusion:Special methods should be taken,according to the risk factors of VAP,to decrease the incidence rate of VAP in China.