我国肺癌患者医院感染高危因素Meta分析

Risk factors for healthcare-associated infection in patients with lung cancer in China:A Meta-analysis

目的系统分析肺癌患者医院感染高危因素及合并症特征,为制订医院感染管理策略提供依据。方法检索中国生物医学文献数据库(CBM)、中国知识基础设施工程(CNKI),万方、维普、PubMed以及Embase数据库中肺癌患者医院感染相关文献,提取数据进行Meta分析。结果共纳入19篇文献,包括肺癌住院患者8 069例,其中医院感染1 280例。医疗因素发生医院感染的Meta分析合并值:抗肿瘤治疗(放射治疗和化学治疗)、化学治疗次数(≥2次)、预防性使用抗菌药物、使用免疫抑制剂及侵入性操作OR及95%CI分别为3.13(1.82,5.39)、9.20(3.04,27.87)、3.23(1.77,5.91)、2.00(1.56,2.57)、2.28(1.81,2.88);肺癌不同合并症发生医院感染的Meta分析合并值:肺部疾病、慢性阻塞性肺疾病(COPD)、糖尿病、肾功能不全、营养不良、低蛋白血症、中性粒细胞减少、白细胞减少症OR及95%CI分别为2.65(1.74,4.02)、2.40(1.76,3.27)、2.25(1.85,2.73)、2.56(1.18,5.52)、5.51(1.70,17.89)、2.05(1.56,2.70)、3.38(1.40,8.18)、2.10(1.22,3.62)。结论肺癌患者医院感染相关医疗及合并症因素复杂多样,抗肿瘤治疗、免疫抑制剂、预防性使用抗菌药物、侵入性操作、肺部疾病、COPD、糖尿病、肾功能不全、营养不良、低蛋白血症、中性粒细胞减少及白细胞减少等均为肺癌患者医院感染的高危因素。

Objective To analyze risk factors and complication characteristics of healthcare-associated infection （HAI）in patients with lung cancer,and provide evidence for the formulation of HAI management strategy. Methods HAI-related articles were retrieved from China Biology Medicine （CBM）,China National Knowledge Infrastructure （CNKI）,Wanfang database,Vip database,PubMed,and Embase,all data were conducted Meta-analysis.Results A total of 19 articles involving 8 069 hospitalized patients with lung cancer （1 280 had HAI）were included.Meta-analysis on combined values of medical factors for HAI were as follows：OR（95%CI ）of anti-tumor therapy（radiotherapy and chemotherapy）,number of chemotherapy （≥ 2 times ）,antimicrobial prophylaxis, immunosuppressant therapy,and invasive operation were 3.13 （1 .82,5.39）,9.20 （3.04,27.87）,3.23 （1 .77, 5.91）,2.00（1 .56,2.57）,and 2.28（1 .81 ,2.88）,respectively;Meta-analysis on combined values of complication factors for HAI were as follows：OR （95% CI ）of pulmonary diseases,chronic obstructive pulmonary disease （COPD）,diabetes,renal dysfunction,malnutrition,hypoalbuminemia,neutropenia,and leukopenia were 2.65 （1 .74,4.02）,2.40 （1 .76,3.27）,2.25 （1 .85,2.73 ）,2.56 （1 .18,5.52）,5.51 （1 .70,17.89）,2.05 （1 .56, 2.70）,3.38（1 .40,8.18）,and 2.10 （1 .22,3.62）,respectively.Conclusion HAI-related factors of medical treat-ment and complications in patients with lung cancer are diversity,risk factors for HAI in patients with lung cancer are anti-tumor therapy,immunosuppressant therapy,antimicrobial prophylaxis,invasive operation,pulmonary dis-eases,COPD,diabetes,renal dysfunction,malnutrition,hypoalbuminemia,neutropenia,and leucopenia.