摘要
目的 对新生儿发生院内感染的主要危险因素进行Meta分析,以进一步完善医疗防御措施,减少新生儿医院感染的发生.方法 检索中英文数据库,采用STATA/SE 12.0软件进行Meta分析.结果 共纳入52篇研究,94 223例感染新生儿.Meta分析表明12个危险因素差异有统计学意义,其中胎龄＜37 周(RR=0.92,95％CI=0.90～0.93)、出生体质量＜2 500 g(RR=0.92,95％CI=0.91～0.94)、住院时间＞7 d(RR=0.93,95％CI=0.91～0.95)、机械通气(RR=0.88,95％CI=0.85～0.91)、肠外营养(RR=0.92,95％CI=0.89～0.96)、侵入性操作(RR=0.89,95％CI=0.84～0.93)、静脉置管(RR=0.91,95％CI=0.83～0.99)、新生儿窒息(RR=0.94,95％CI=0.89～0.99)、分娩方式(RR=0.93,95％CI=0.88～0.98)、经外周静脉穿刺中心静脉置管术(RR=0.84,95％CI=0.74～0.96)、羊水浑浊(RR=0.91,95％CI=0.85～0.96)及母乳喂养(RR=0.93,95％CI=0.87～1.00)为新生儿感染的危险因素,敏感性分析与漏斗图结果显示发表偏倚不明显.结论 在新生儿护理及临床工作中,医护人员应提高对新生儿感染危险因素的识别及判断,积极主动实行防范措施,减少新生儿医院感染的患病率和致死率.
Abstract
Objective To make a Meta-analysis of the main risk factors for neonatal nosocomial infection,so as to further improve medical preventive measures and reduce the incidence of neonatal nosocomial infection.Methods Both Chinese and foreign databases were searched,and STATA/SE 12.0 software was used for Meta-analysis.Results Totally 52 studies were included,involving 94 223 neonates with infection.Meta-analysis showed that 12 risk factors were with statistically significant difference,including gestational age＜37 weeks(RR=0.92,95％CI=0.90-0.93),birth weight＜2 500 g(RR=0.92,95％CI=0.91-0.94),hospital stay＞7 days(RR=0.93,95％CI=0.91-0.95),mechanical ventilation(RR=0.88,95％CI=0.85-0.91),parenteral nutrition(RR=0.92,95％CI=0.89-0.96),invasive procedures(RR=0.89,95％CI=0.84-0.93),intravenous catheterization(RR=0.91,95％CI=0.83-0.99),neonatal asphyxia(RR=0.94,95％CI=0.89-0.99),mode of delivery(RR=0.93,95％CI=0.88-0.98),PICC(RR=0.84,95％CI=0.74-0.96),amniotic fluid turbidity(RR=0.91,95％CI=0.85-0.96)and breast feeding(RR=0.93,95％CI=0.87-1.00),which were risk factors for neonatal infection.Sensitivity analysis and publication bias results showed that the publication bias was not obvious.Conclusion In neonatal nursing and clinical work,medical staff should improve the identification and judgment of risk factors for neonatal infection and actively take preventive measures in order to reduce the morbidity and mortality of neonatal nosocomial infection.
基金项目
甘肃省人民医院院内科研项目(23GSSYF-9)
甘肃省名中医张定华传承工作室建设项目(甘卫中医函[2022]50号)
维普
万方数据