食管癌患者术后肺部感染危险因素的meta分析

Risk factors of postoperative pulmonary infection in patients with esophageal cancer:a meta-analysis

目的系统评价食管癌患者术后肺部感染的危险因素。方法计算机检索SinoMed、PubMed、EMBASE、Web of Science、the Cochrane Library、CINAHL、CBM、中国知网、万方及维普数据库,收集建库至2021年6月公开发表的关于食管癌患者术后肺部感染的文献,采用RevMan5.3和Stata16.0软件进行meta分析。结果共纳入19篇文献,涉及患者6529例。年龄大于或等于60岁、吸烟史、糖尿病、慢性阻塞性肺疾病、冠心病、低蛋白血症、肿瘤位于上中段、手术时间大于或等于4 h、行开胸手术、单肺通气、术中出血量大于800 mL、术后未使用自控硬膜外镇痛、酸抑制剂使用时间、喉返神经损伤是食管癌患者术后肺部感染的危险因素(P<0.05)。结论食管癌患者术后肺部感染危险因素较多,医护人员应重视相关危险因素,早期预防、早期干预,从而降低患者肺部感染发生率,改善患者生活质量和预后。

Objective To systematically evaluate the risk factors of postoperative pulmonary infection in patients with esophageal cancer.Methods The databases of SinoMed,PubMed,EMBASE,Web of Science,the Cochrane Library,CINAHL,CBM,CNKI,Wanfang and VIP were searched by computer.The literature on postoperative pulmonary infection in patients with esophageal cancer published from the establishment of the database to June 2021 was collected.The meta-analysis was performed by using RevMan5.3 and Stata16.0 software.Results A total of 19 literatures involving 6529 patients were included.Age greater than or equal to 60 years old,smoking history,diabetes,chronic obstructive pulmonary disease,coronary heart disease,hypoproteinemia,tumor located in the upper middle part,operation time greater than or equal to 4 h,open chest surgery,one lung ventilation,intraoperative blood loss greater than 800 mL,postoperative no use of auto-controlled epidural analgesia,use time of acid inhibitor,and recurrent laryngeal nerve injury were risk factors for postoperative pulmonary infection in patients with esophageal cancer(P<0.05).Conclusion There are many risk factors of postoperative pulmonary infection in patients with esophageal cancer.Medical staff should pay attention to relevant risk factors,early prevention and early intervention,so as to reduce the incidence of pulmonary infection and improve the quality of life and prognosis of patients.