阿尔兹海默病患者医院感染危险因素的meta分析

Risk factors of nosocomial infections in patients with senile dementia

目的系统评价我国阿尔兹海默病(AD)患者医院感染危险因素的相关研究,为制定医院感染控制策略提供依据。方法计算机检索万方、VIP、CBM、CNKI数据库文献,由两名研究者根据纳入排除标准独立筛选文献、提取资料和质量评价后,用Rev.Man 5.3软件进行Meta分析。结果纳入15个研究,共2 456例老年痴呆患者,Meta分析结果显示:老年痴呆患者合并低蛋白血症、合并吞咽障碍、侵入性操作、抗菌药物使用不规范、长期服用抗精神病药物、留置导尿、抗菌药物使用时间≥7d、病房床位数≥3张是重要的医院感染危险因素(P<0.05)。结论 AD患者医院感染的危险因素繁多,需要采取针对性的预防措施控制AD患者的医院感染。

OBJECTIVE To systematically review all related studies of risk factors of nosocomial infections in patients with senile dementia,so as to provide the evidence for the development of nosocomial infection control strategy.METHODS All clinical literatures in Wanfang,VIP,CBM and CNKI were retrieved.Two assessors independently screened the literatures,extracted data and evaluated the quality.After screening,all included data were analyzed by RevMan 5.3software for Meta-analysis.RESULTS Totally 15 studies involving 2456 patients with senile dementia were included.Meta-analysis results showed that the main risk factors of nosocomial infections in senile dementia patients were hypoproteinemia,dysphagia,invasive operation,using antibiotics not standardized,long term use of antipsychotic drugs,indwelling catheterization,using antibiotics more than 7days and the number of beds in the ward more than 3（P〈0.05）.CONCLUSION Risk factors of nosocomial infections in patients with senile dementia are diversity.Targeted preventive measures should be taken to control nosocomial infections in patients with senile dementia.