神经外科系统疾病合并医院获得性肺炎危险因素荟萃分析

Risk factors of hospital-acquired pneumonia in patients with neurosurgical diseases:a Meta analysis

目的评价神经外科系统疾病并发医院获得性肺炎（HAP）的危险因素。方法利用荟萃分析对2001-2009年神经外科相关疾病合并医院获得性肺炎危险因素的文献进行定量分析,计算每个危险因素的综合OR值。结果检索2001-2009年文献,共有17篇符合该次调查范围,17篇文章共统计9386例患者,其中2490例发生HAP,发生率为26.53%;有12个因素差异有统计学意义,分别为：机械通气、意识障碍、鼻饲、吞咽困难、肺部疾病、使用H2阻滞剂、住院天数、气管切开、糖尿病、年龄、吸烟史、预防应用抗菌药物,发生相关因素的感染率在22.89%~65.94%。结论机械通气、意识障碍、鼻饲、吞咽困难、肺部疾病、使用H2阻滞剂、住院天数、气管切开、糖尿病、年龄、吸烟史、预防应用抗菌药物等是神经外科系统疾病并发医院获得性肺炎的危险因素。

OBJECTIVE To evaluate the risk factors of hospital-acquired pneumonia in patients with neurosurgical diseases.METHODS Totally 17 literatures from 2001-2009 were selected according to the criteria and assessed by Meta-analysis.The pools OR values of influencing factors were calculated.RESULTS Twelve risk factors showed statistical significance,which were mechanical ventilation,conscious disorder,nasogastric gavage,dysphagia,the underlying pulmonary diseases,H2-receptor blocker,length of Hospital stay,tracheotomy,diabetes,the age,smoking history and prophylactic antibiotics,the infection rates of the related factors were between 22.89% and 65.94%.CONCLUSION Mechanical ventilation,conscious disorder,nasogastric gavage,dysphagia,the underlying pulmonary diseases,H2-receptor blocker,length of Hospital stay,tracheotomy,diabetes,the age,smoking history and prophylactic antibiotics are the risk factors of hospital-acquired pneumonia in the patients with neurosurgical diseases.