ICU病人暴露性角膜炎危险因素的Meta分析

Meta-analysis of risk factors of exposure keratitis in ICU patients

目的:探讨重症监护室(ICU)病人发生暴露性角膜炎的危险因素,为暴露性角膜炎的防治提供参考依据。方法:计算机检索中国知网、中国生物医学文献服务系统、万方数据库、PubMed、EMbase、CINAHL、the Cochrane Library、Joanna Briggs Institute数据库中有关ICU病人暴露性角膜炎危险因素的研究,检索时间为建库至2020年9月25日。采用RevMan 5.3软件进行Meta分析。结果:最终纳入8篇队列研究。Meta分析显示,年龄增加[OR=1.02,95%CI(1.01,1.04),P=0.010]、序贯器官功能衰竭评估得分高[OR=1.11,95%CI(1.06,1.16),P<0.00001]、急性生理与慢性健康状况评估系统Ⅱ得分高[OR=1.03,95%CI(1.02,1.05),P=0.0002]、格拉斯哥昏迷量表得分低[OR=1.20,95%CI(1.16,1.25)P<0.00001]、球结膜水肿[OR=2.00,95%CI(1.43,2.79),P<0.0001]、眼睑闭合不全[OR=19.15,95%CI(17.10,21.45),P<0.00001]、每分钟眨眼<5次[OR=5.65,95%CI(3.63,8.80),P<0.00001]、机械通气[OR=6.77,95%CI(3.12,14.69),P<0.00001]是ICU病人发生暴露性角膜炎的危险因素。结论:现有证据表明,ICU病人暴露性角膜炎的发生与多种因素有关,医务人员在工作中应及时关注病人的眼部情况,做好防护措施,预防暴露性角膜炎的发生。

Objective:To explore the risk factors of exposure keratitis in intensive care unit(ICU)patients,so as to provide reference basis for the prevention and treatment of exposure keratitis.Methods:Studies on risk factors for exposure keratitis in ICU patients were searched from CNKI,SinoMed,WanFang Database,PudMed,EMbase,CINAHL,the Cochrane Library and Joanna Briggs Institute.The retrieval time was from inception to September 25,2020.RevMan 5.3 software was used for the Meta-analysis.Results:A total of 8 cohort studies were included.Meta-analysis results showed that age increase[OR=1.02,95%CI(1.01,1.04),P=0.010],high SOFA score[OR=1.11,95%CI(1.06,1.16),P<0.00001],high APACHEⅡscore[OR=1.03,95%CI(1.02,1.05),P=0.0002],low GCS score[OR=1.20,95%CI(1.16,1.25)P<0.00001],conjunctival edema[OR=2.00,95%CI(1.43,2.79),P<0.0001],lagophthalmos[OR=19.15,95%CI(17.10,21.45),P<0.00001],eye blinks<5 times per minute[OR=5.65,95%CI(3.63,8.80),P<0.00001],and mechanical ventilation[OR=6.77,95%CI(3.12,14.69),P<0.00001]were risk factors for exposure keratitis in ICU patients.Conclusions:Current evidences show that the occurrence of exposure keratitis in ICU patients is related to many factors.Medical staff should pay timely attention to the patient′s eye conditions and take protective measures to prevent the occurrence of exposure keratitis.