摘要
目的系统评价喉癌患者发生术后医院感染的危险因素,为临床护理干预提供参考。方法计算机检索PubMed、Embase、Web of Science、The Cochrane Library、CBM、Wanfang、CNKI和VIP等国内外相关数据库,检索时限自建库至2023年11月喉癌患者发生术后感染危险因素的相关文献。对符合纳入标准的文献进行质量评价、提取资料、结果分析。结果共纳入22篇文献,包含3738例研究对象。Meta分析结果显示:全喉切除术(OR=1.85,95%CI:1.60~2.13)、手术时间>4 h(OR=2.80,95%CI:2.28~3.43)、应用抗菌药物≥5 d(OR=3.28,95%CI:2.52~4.26)、临床分期≥Ⅲ期(OR=2.23,95%CI:1.77~2.81)、合并糖尿病(OR=2.45,95%CI:2.04~2.95)、合并肺部疾病(OR=1.82,95%CI:1.47~2.26)、年龄(OR=1.17,95%CI:1.14~1.20)、留置胃管(OR=6.43,95%CI:5.04~8.20)、他用呼吸机(OR=4.40,95%CI:3.22~6.02)、术前行气管切开(OR=1.80,95%CI:1.33~2.84)、吸烟(OR=1.73,95%CI:1.26~2.37)、拔管时间≥12 d(OR=4.21,95%CI:2.83~6.27)、术后营养支持(OR=4.39,95%CI:1.81~10.61)为喉癌患者发生术后感染的主要影响因素。结论喉癌患者术后感染的影响因素较多,临床医护人员应根据患者情况实施精准干预,减少术后感染的发生。
Objective To systematically evaluate the risk factors of postoperative nosocomial infection in patients with laryngeal cancer,and to provide reference for clinical nursing intervention.Methods The literature on the risk factors of postoperative infection in patients with laryngeal cancer was searched by computer from PubMed,Embase,Web of Science,the Cochrane Library,CBM,Wanfang,CNKI,VIP and other relevant databases at home or abroad from self-built database to November 2023.The quality evaluation,data extraction and results analysis were carried out for the literature meeting the inclusion criteria.Results A total of 22 articles were included,including 3738subjects.The results of meta-analysis showed that,Total laryngectomy(odds ratio OR=1.85,95%confidence interval CI:1.60-2.13),surgery duration>4 hours(OR=2.80,95%CI:2.28-3.43),use of antimicrobial drugs≥5 d(OR=3.28,95%CI:2.52-4.26),clinical stage≥Ⅲ(OR=2.23,95%CI:1.77-2.81),comorbid diabetes(OR=2.45,95%CI:2.04-2.95),pulmonary diseases(OR=1.82,95%CI:1.47-2.26),age(OR=1.17,95%CI:1.14-1.20),nasogastric tube placement(OR=6.43,95%CI:5.04-8.20),Use a ventilator(OR=4.40,95%CI:3.22-6.02),preoperative tracheostomy(OR=1.80,95%CI:1.33-2.84),smoking(OR=1.73,95%CI:1.26-2.37),extubation time≥12 d(OR=4.21,95%CI:2.83-6.27)and postoperative nutritional support(OR=4.39,95%CI:1.81-10.61)were main influencing factors for postoperative infection in patients with laryngeal cancer.Conclusions There were many factors affecting postoperative infection in patients with laryngeal cancer.Clinical medical staff should implement precise intervention according to patients'conditions to reduce the incidence of postoperative infection.
作者
柏晓迪
蒋运兰
刘姝兰
徐婷
林思玉
周欣瑶
徐何瑶
BAI Xiaodi;JIANG Yunlan;LIU Shulan;XU Ting;LIN Siyu;ZHOU Xinyao;XU Heyao(Chengdu University of Traditional Chinese Medicine,Chengdu 610072,Sichuan Province,China;Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,Sichuan Province,China)
出处
《预防医学情报杂志》
2025年第12期1638-1645,1690,共9页
Journal of Preventive Medicine Information
关键词
喉癌
术后感染
影响因素
META分析
laryngeal cancer
postoperative infection
influencing factors
Meta-analysis
