我国肺癌患者医院感染高危因素Meta分析

Risk factors for healthcareassociated infection in patients with lung cancer in China:A Metaanalysis

摘要:

目的系统分析肺癌患者医院感染高危因素及合并症特征，为制订医院感染管理策略提供依据。方法检索中国生物医学文献数据库（CBM）、中国知识基础设施工程(CNKI),万方、维普、PubMed以及Embase数据库中肺癌患者医院感染相关文献，提取数据进行Meta分析。结果共纳入19篇文献，包括肺癌住院患者 8 069例，其中医院感染1 280例。医疗因素发生医院感染的Meta分析合并值：抗肿瘤治疗(放射治疗和化学治疗)、化学治疗次数(≥2次)、预防性使用抗菌药物、使用免疫抑制剂及侵入性操作OR及95%CI分别为3.13(1.82,5.39)、9.20(3.04,27.87)、3.23(1.77,5.91)、2.00(1.56,2.57)、2.28(1.81,2.88)；肺癌不同合并症发生医院感染的Meta分析合并值：肺部疾病、慢性阻塞性肺疾病(COPD)、糖尿病、肾功能不全、营养不良、低蛋白血症、中性粒细胞减少、白细胞减少症OR及95%CI分别为2.65(1.74,4.02)、2.40(1.76,3.27)、2.25(1.85,2.73)、2.56 (1.18,5.52)、5.51(1.70,17.89)、2.05(1.56,2.70)、3.38(1.40,8.18)、2.10 (1.22,3.62)。结论肺癌患者医院感染相关医疗及合并症因素复杂多样，抗肿瘤治疗、免疫抑制剂、预防性使用抗菌药物、侵入性操作、肺部疾病、COPD、糖尿病、肾功能不全、营养不良、低蛋白血症、中性粒细胞减少及白细胞减少等均为肺癌患者医院感染的高危因素。

关键词:

肺癌; 医院感染; 医疗因素; 合并症; Meta分析

Abstract:

ObjectiveTo analyze risk factors and complication characteristics of healthcareassociated infection(HAI)  in patients with lung cancer, and provide evidence for the formulation of HAI management strategy. MethodsHAIrelated articles were retrieved from China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wanfang database, Vip database,PubMed, and Embase, all data were conducted Metaanalysis. ResultsA total of 19 articles involving 8 069 hospitalized patients with lung cancer (1 280 had HAI) were included. Metaanalysis on combined values of medical factors for HAI were as follows:  OR(95%CI) of antitumor therapy(radiotherapy and chemotherapy)， number of chemotherapy (≥2 times), antimicrobial prophylaxis, immunosuppressant therapy, and invasive operation were 3.13(1.82,5.39), 9.20(3.04,27.87), 3.23(1.77,5.91), 2.00(1.56,2.57), and 2.28(1.81,2.88), respectively； Metaanalysis on combined values of complication factors for HAI were as follows:  OR(95%CI) of pulmonary diseases，chronic obstructive pulmonary disease (COPD)， diabetes, renal dysfunction， malnutrition, hypoalbuminemia, neutropenia,and leukopenia were 2.65 (1.74, 4.02), 2.40 (1.76, 3.27), 2.25(1.85, 2.73), 2.56(1.18, 5.52), 5.51 (1.70, 17.89), 2.05(1.56, 2.70), 3.38(1.40, 8.18), and 2.10 (1.22, 3.62), respectively. ConclusionHAIrelated factors of medical treatment and complications in patients with lung cancer are diversity, risk factors for HAI in patients with lung cancer are antitumor therapy， immunosuppressant therapy, antimicrobial prophylaxis, invasive operation, pulmonary diseases， COPD，diabetes, renal dysfunction， malnutrition, hypoalbuminemia, neutropenia, and leucopenia.

Key words:

lung cancer; healthcareassociated infection; medical factor; complication; Metaanalysis