摘要
目的:对机械通气病人多重耐药菌感染的危险因素进行系统评价。方法:计算机检索PubMed、EMbase、Web of Science、the Cochrane library、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库(WanFang Database)、维普数据库(VIP)中发表的机械通气病人多重耐药菌感染危险因素的相关文献,2名研究人员独立进行文献检索、筛选、质量评价与数据提取,并使用RevMan 5.4.1软件进行数据分析。结果:最终纳入15篇相关文献,涉及5 290例机械通气病人,其中多重耐药菌感染者1 463例。Meta分析结果显示,吸烟、合并慢性阻塞性肺疾病、血白蛋白<30 g/L、气管切开、多次气管插管、机械通气时间≥7 d、抗菌药物联用、使用碳青霉烯类抗菌药物及含β-内酰胺酶抑制剂类抗菌药物、抗菌药物使用时间≥7 d、糖皮质激素治疗>3 d是机械通气病人多重耐药菌感染的危险因素。结论:现有证据表明,吸烟、合并慢性阻塞性肺疾病、血白蛋白<30 g/L、械通气时间≥7 d、气管切开、多次气管插管、抗菌药物联用、使用碳青霉烯类抗菌药物及含β-内酰胺酶抑制剂抗生素、糖皮质激素治疗>3 d是机械通气病人多重耐药菌感染的危险因素。医务人员应针对以上危险因素进行精准干预,以降低机械通气病人多重耐药菌感染风险。
Objective:To systematicly evaluate the risk factors of multidrug-resistant organism infection in patients with mechanical ventilation.Methods:Related literatures on risk factors of multidrug-resistant organism infection in patients with mechanical ventilation were searched from PubMed, EMbase, Web of Science, the Cochrane library, CBM,CNKI,WanFang Database, VIP.Two researchers independently carried out literature retrieval, screening, quality evaluation and data extraction, and RevMan 5.4.1 software was used for data analysis.Results:A Total of 15 articles were included, involving 5 290 patients with mechanical ventilation, including 1 463 patients with multidrug-resistant organism infection.Meta-analysis results showed that smoking, combined chronic obstructive pulmonary disease, serum albumin<30 g/L,tracheotomy, multiple endotracheal intubations, mechanical ventilation time ≥ 7 days, antibacterial drug combination, using penicillium carbon alkene antimicrobial and β-lactamase inhibitor containing antimicrobial, antibacterial drug use time ≥7 days, glucocorticoid treatment>3 days were risk factors for multidrug-resistant organism infection in inpatients with mechanical ventilation.Conclusion:Current evidence shows that smoking, combined chronic obstructive pulmonary disease, serum albumin<30 g/L,tracheotomy, multiple endotracheal intubations, mechanical ventilation time ≥ 7 days, antibacterial drug combination, using penicillium carbon alkene antimicrobial and β-lactamase inhibitor containing antimicrobial, antibacterial drug use time ≥7 days, glucocorticoid treatment>3 days are risk factors for multidrug-resistant organism infection in in patients with mechanical ventilation.Medical staff should carry out precise intervention against risk factors to reduce the risk of multidrug-resistant organism infection in patients with mechanical ventilation.
作者
魏静静
吴海清
杨涛
余浩辉
陶胜茹
WEI Jingjing;WU Haiqing;YANG Tao;YU Haohui;TAO Shengru(School of Nursing,Jinan University,Guangdong 510632 China)
出处
《循证护理》
2023年第2期200-206,共7页
Chinese Evidence-Based Nursing
基金
广东省医学科学技术研究基金项目,编号:B2021245。
关键词
机械通气
多重耐药菌
危险因素
META分析
循证护理
mechanical ventilation
multidrug-resistance organism
risk factors
Meta-analysis
EVIDENCE-BASED nursing
