脑梗死患者医院感染相关因素的Meta分析

Related factors for nosocomial infection in patients with cerebral infarction:a meta-analysis

目的系统评价脑梗死患者发生医院感染的相关因素,为制定感染防控策略提供依据。方法计算机检索建库-2017年7月万方、CNKI、VIP、CBM、Pubmed、Embase、Cochrane、Web of Science数据库文献,由两名评价员根据纳入及排除标准独立筛选文献、提取数据和质量评价后,采用RevMan5.3软件进行Meta分析。结果纳入22个研究,涉及8 278例脑梗死患者,合并医院感染1 730例。Meta分析结果显示:意识障碍(OR=6.26)、吞咽困难(OR=9.02)、低蛋白血症(OR=4.18)、留置胃管(OR=7.80)、应用呼吸机(OR=6.00)、气管切开(OR=4.67)、住院时间≥20天(OR=9.86)、平均年龄大(MD=4.98)、NIHSS评分高(MD=3.74)是脑梗死患者重要的医院感染的相关因素(P<0.05)。结论脑梗死患者医院感染的相关因素纷繁复杂,需采取针对性的预防措施控制感染。

OBJECTIVE To systematically review the related factors for nosocomial infection in patients with cerebral infarction so as to formulate prevention strategies.METHODS The databases,including Wanfang,CNKI,VIP,CBM,Pubmed,Embase,Cochrane and Web of Science,were retrieved for literatures from the establishment of the databases to 2017,the literatures were screened independently by two reviewers according to the inclusion and exclusion criteria,the data were extracted,the quality was evaluated,and the meta-analysis was performed by using RevMan5.3 software.RESULTS Totally 22 studies were included,involving 8 278 patients with cerebral infarction and 1 730 patients complicated with nosocomial infection.The result of the meta-analysis showed that the related factors for the nosocomial infection in the patients with cerebral infarction included disturbance of consciousness（OR=6.26）,dysphagia（OR=9.02）,hypoproteinemia（OR=4.18）,gastric tube indwelling（OR=7.80）,use of ventilator（OR=6.00）,tracheotomy（OR=4.67）,length of hospital stay no less than 20 days（OR=9.86）,old mean age（MD=4.98）and high NIHSS（P〈0.05）.CONCLUSIONThere are a variety of related factors for the nosocomial infection in the patients with cerebral infarction.It is necessary to take targeted prevention measures.