新生儿呼吸机相关性肺炎危险因素的Meta分析

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

目的系统评价中国新生儿呼吸机相关性肺炎(VAP)的危险因素,为临床制订预防策略提供依据。方法检索PubMed、Web of Science、中国知网(CNKI)、中国生物医学文摘数据库(CBM)、重庆维普(VIP)和万方数据库,收集研究中国新生儿VAP危险因素的文献,按照纳入和排除标准筛选文献、提取数据并采用Revman5.1软件进行Meta分析。结果根据纳入排除标准,最终纳入20篇文献,病例1 145例,对照2 610例。影响新生儿发生VAP的危险因素包括机械通气(MV)≥3d、原发性肺部疾病、头部仰卧位、鼻胃管、早产、重插管、低体质量、血制品应用、剖宫产及肠外营养。结论临床上应针对中国新生儿VAP发病的相关危险因素采取针对性预防措施,从而降低VAP的发病率和病死率。

Objective To provide references for VAP prevention strategy through systematically review on the risk factors of neonatal ventilator‐associated pneumonia（VAP） in China .Methods Literatures of neonatal VAP were searched in PubMed ,Web of Science ,CNKI ,CBM ,VIP and WanFang databases .Literatures screening and data extraction were conducted according to the inclu‐sion and exclusion criteria .Meta‐analysis were calculated using software Revman5 .1 .Results 20 studies were included .1 145 cases of Patients and 2 610 cases in cantrol group .The 10 possible risk factors related to neonatal VAP were MV ≥3 days ,underlying lung disease ,supine ,nasal feeding and gastric tube ,preterm delivery ,reintubation ,underweight ,transfusion ,cesarean delivery and parenteral nutrition .Conclusion The targeted methods considering the above factors should be taken to decrease the morbidity and mortality of VAP in China .