脑卒中患者发生压力性溃疡危险因素Meta分析

Risk factors for pressure ulcer in stroke patients: a Meta-analysis

目的 系统评价脑卒中患者发生压力性溃疡的危险因素。方法 通过计算机检索中国知网数据库、万方数据库、维普数据库、中国生物医学文献数据库、Pubmed、EMBASE、Web of Science、Cochrane Library等自建库起至2021年5月1日收录的关于脑卒中患者发生压力性溃疡危险因素的病例对照研究。由2名研究者根据纳入与排除标准对文献进行筛选与评价,采用RevMan 5.4软件进行Meta分析。结果 本研究共纳入文献12篇。Meta分析结果显示,营养障碍(OR=2.88,95%可信区间2.15~3.87,P<0.001)、感觉功能障碍(OR=2.17,95%可信区间1.60~2.93,P<0.001)、年龄(OR=4.66,95%可信区间3.48~6.26,P<0.001)、潮湿环境(OR=3.78,95%可信区间2.66~5.36,P<0.001)、摩擦力(OR=3.28,95%可信区间2.27~4.73,P<0.001)、剪切力(OR=2.24,95%可信区间1.92~2.61,P<0.001)、失禁(OR=4.07,95%可信区间2.66~6.23,P<0.001)、美国国立卫生研究院卒中量表评分(OR=1.32,95%可信区间1.25~1.39,P<0.001)、压力(OR=4.71,95%可信区间1.82~12.19,P=0.001)、意识障碍(OR=3.94,95%可信区间1.38~11.29,P=0.010)、翻身能力(OR=7.09,95%可信区间3.07~16.35,P<0.001)、活动力(OR=3.21,95%可信区间1.47~7.01,P=0.003)、血清白蛋白水平(OR=1.38,95%可信区间1.15~1.67,P<0.001)是脑卒中患者发生压力性溃疡的独立危险因素。结论 营养障碍、感觉功能障碍、年龄、潮湿环境、摩擦力、剪切力、失禁、美国国立卫生研究院卒中量表评分、压力、意识障碍、翻身能力、活动力、血清白蛋白水平是脑卒中患者发生压力性溃疡的独立危险因素。临床中,应针对上述危险因素制定预防管理措施,以降低脑卒中患者压力性溃疡的发生率。

Objective To systematically evaluate the risk factors for pressure ulcer in stroke patients.Methods CNKI,WanFang,VIP,CBM,Pubmed,EMBASE,Web of Science and the Cochrane Library database were electronically searched to collect the case control studies about the risk factors for pressure ulcer in stroke patients from the database inception to May 1st,2021.Two reviewers screened and evaluated the literatures according to the inclusion and exclusion criteria,Meta-analysis was performed by RevMan 5.4software.Results A total of 12 articles were collected.The Meta-analysis results showed that nutritional impairment[OR =2.88,95%confidence interval(CI) 2.15 to 3.87,P<0.001],sensory dysfunction(OR=2.17,95%CI 1.60 to 2.93,P<0.001),age(OR=4.66,95%CI 3.48 to 6.26,P<0.001),moist environment(OR=3.78,95%CI 2.66 to 5.36,P<0.001),friction(OR=3.28,95%CI 2.27 to 4.73,P<0.001),shear force(OR=2.24,95%CI 1.92 to 2.61,P<0.001),incontinence(OR=4.07,95%CI 2.66 to 6.23,P<0.001),National Institute of Health Stroke Scale score(OR =1.32,95%CI 1.25 to 1.39,P <0.001),stress(OR =4.71,95%CI 1.82 to 12.19,P=0.001),impaired consciousness(OR=3.94,95%CI 1.38 to 11.29,P=0.010),turnover ability(OR=7.09,95%CI 3.07 to 16.35,P<0.001),mobility(OR=3.21,95%CI 1.47 to 7.01,P=0.003),serum albumin level(OR=1.38,95%CI 1.15 to 1.67,P<0.001) were independent risk factors for pressure ulcer in stroke patients.Conclusion Nutritional impairment,sensory dysfunction,age,moist environment,friction,shear force,incontinence,National Institute of Health Stroke Scale score,stress,impaired consciousness,turnover ability,mobility,serum albumin level are risk factors for pressure ulcer in stroke patients.The clinicians should formulate relevant preventive management measures according to the above risk factors,in order to reduce the incidence rate of pressure ulcer in stroke patients.