血液透析患者导管相关性血流感染危险因素的Meta分析

Risk factors of catheter-related bloodstream infection in hemodialysis patients:a Meta-analysis

目的通过Meta分析明确血液透析患者发生导管相关性血流感染的危险因素。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库,搜集血液透析患者导管相关性血流感染危险因素的研究。由2名研究者按照标准独立进行文献筛选、资料提取并且评价文献质量后,采用RevMan 5.3软件进行Meta分析。结果共纳入10篇文献,包括3143例研究对象,共7项危险因素。Meta分析显示,导管留置时间(OR值为2.59,95%CI 1.18~5.68)、置管次数(OR值为10.02,95%CI 5.93~16.92)、股静脉置管(OR值为1.73,95%CI 1.32~2.25)、年龄(OR值为1.94,95%CI 1.50~2.51)、合并糖尿病(OR值为2.58,95%CI 2.03~3.29)以及血红蛋白水平(OR值为1.61,95%CI 1.18~2.18),各组差异有统计学意义(P<0.05)。结论导管留置时间、置管次数、股静脉置管、年龄、合并糖尿病、血红蛋白水平是血液透析患者发生导管相关性血流感染的主要危险因素。而白蛋白水平与导管相关性血流感染的关系有待纳入更多的研究进一步验证。

Objective To identify the risk factors of catheter-related bloodstream infection in hemodialysis patients using Meta-analysis.Methods We searched PubMed,Web of Science,Cochrane Library,Embase,CBM,CNKI and Wangfang Data to collect literature about risk factors of catheter-related bloodstream infection in hemodialysis patients.Data were analyzed by RevMan 5.3 after literature screening,data extraction,and quality appraisal according to criteria by two researchers independently.Results Ten literatures were recruited,including 3143 cases and 7 risk factors.According to Meta analysis,catheter indwelling time(OR value was 2.59,95%CI 1.18-5.68),times of intubation(OR value was 10.02,95%CI 5.93-16.92),femoral vein catheterization(OR value was 1.73,95%CI 1.32-2.25),age(OR value was 1.94,95%CI 1.50-2.51),diabetes mellitus(OR value was 2.58,95%CI 2.03-3.29)and hemoglobin level(OR value was 1.61,95%CI 1.18-2.18),were significantly different in each group(all P<0.05).Conclusions The main of risk factors for catheter-related bloodstream infection in hemodialysis patients are catheter indwelling time,times of intubation,femoral vein catheterization,age,diabetes mellitus and hemoglobin level.However,the relationship between catheter-related bloodstream infection and albumin level needs to be confirmed by more studies.