我国住院患者压疮现患率及医院获得性压疮现患率的Meta分析

The prevalence of pressure ulcer and hospital acquired pressure ulcer in hospitalized patients in China: a Meta-analysis

目的:通过Meta分析了解我国住院患者压疮现患率及医院获得性压疮现患率。方法:检索CNKI、Wanfang、VIP、CBM、Pubmed及Web of Science数据库从建库至2018年2月发表的相关文献;对纳入文献进行Meta分析,并对性别、年龄、压疮分期、科室、压疮部位等进行亚组分析。结果:纳入20篇文献进行Meta分析,研究总样本量为422 523例,压疮患者4 019例,其中17篇文献报道了医院获得性压疮发生人数共计709例。Meta分析结果显示,我国住院患者压疮现患率为1.67%,医院获得性压疮现患率为0.68%;亚组分析中,男性压疮现患率为1.19%,高于女性压疮现患率(0.69%);大于80岁年龄段患者的压疮现患率最高(5.33%);I期和II期压疮现患率较高,分别为0.59%、0.50%;ICU患者压疮现患率最高(18.76%);骶尾部压疮现患率最高(0.70%),其次是足跟部(0.13%)、髂嵴(0.10%)和大转子(0.10%,仅一篇文献);华南地区压疮现患率最高(3.98%),华北地区最低(0.56%,仅一篇文献);二级医院压疮现患率高于三级医院,分别为2.55%(仅一篇文献)、1.70%;按发表年份分组,我国住院患者压疮现患率呈上升趋势。结论:不同特征人群压疮现患率不同,男性、高年龄、ICU患者、华南地区及二级医院是需要关注的高发群体,I期、II期压疮是临床重要防控目标,骶尾、足跟、髂嵴及大转子部位是压疮好发部位,需重点检查,每年应进行压疮现患率调研,以获得压疮现况资料,为临床护理工作提供依据。

Objective： To know the prevalence of pressure ulcer in hospitalized patients and hospital acquired pressure ulcer in China through Meta-analysis. Methods： CNKI, Wanfang, VIP, CBM, Pubmed and Web of Science were searched for Meta analysis. The subgroups analysis of gender, age, ulcer stage, department, pressure ulcer area, regional, level of hospitals and year were conducted. Results： A total of 20 studies were included. The total sample size for the study was 422 523 cases and 4 019 cases of pressure ulcers. Of these, 17 reported 709 cases of hospital-acquired pressure ulcers. Meta-analysis showed that the prevalence of pressure ulcer in hospitalized patients was 1.67% and 0.68% in hospital-acquired pressure ulcers in China. In the subgroup analysis, the prevalence of pressure ulcers in men was 1.19%, which was higher than that of female patients with 0.69%; The highest prevalence of pressure ulcer was 5.33% in patients over 80 years old; The prevalence of stage I and II pressure ulcers were 0.59% and 0.50%, which was higher than other ulcer staging group. The prevalence of pressure ulcer in ICU patients was the highest with 18.76%; The prevalence of sacrococcygeal pressure ulcer was the highest with 0.70%, and followed by heel with 0.13%, iliac with 0.10% and greater trochanter with 0.10% （only one article）; The prevalence of pressure ulcer in south China was the highest with 3.98% and lowest in north China was 0.56% （only one article）; The prevalence rate of pressure sores in secondary hospitals was higher than that in tertiary hospitals, with 2.55% （only one article） to 1.70%. Grouped by the year of publication, the prevalence of pressure sores in hospitalized patients in China is on an upward trend. Conclusions： The current prevalence of pressure ulcer in different populations is different. Men, the aged, ICU patients, patients in south China and secondary hospitals are more likely to get the pressure ulcer. To prevent the occurrence of pressure ulcers, those in stage I and II need more care. Sacrococcygeal, heel, iliac crest and the greater trochanter site are a key site for pressure ulcers, and need more attention. The annual rate of pressure ulcers need to be investigated to get complete prevalence of pressure ulcer, and to provide reference for clinical nursing.