中央导管相关血流感染管理成效序贯分析

Trial sequential analysis on effectiveness in the management of central line-associated bloodstream infection

摘要:

目的 旨在评估采取感染控制干预措施预防中央导管相关血流感染（CLABSI）的管理成效。 方法 计算机系统检索2010年1月—2020年12月国内外数据库中关于CLABSI预防控制的国内研究，提取原始研究中的报告数据，合并OR值及95%置信区间（CI），并对干预方式进行归纳。 结果 共检索263篇研究，其中142篇纳入最终分析，近十年CLABSI预防控制成效显著（OR=0.26，95%CI：0.24~0.29），约68.53%的CLABSI是可预防的，研究间无异质性，总涉及43 614例患者，远超过试验序贯分析界值。 结论 近十年国内CLABSI预防控制成效显著，无需进行更多试验证明，日后可根据2021版指南开展后续质量改进研究，进一步降低血管导管相关感染发生率。

Abstract:

Objective To evaluate the management effectiveness of infection control intervention measures in preventing central line-associated bloodstream infection (CLABSI). Methods The domestic studies on prevention and control of CLABSI in domestic and foreign databases from January 2010 to December 2020 were retrieved through computer system, the reported data in the original study were extracted, OR value and 95% confidence interval (CI) were combined, intervention methods were summarized. Results A total of 263 studies were retrieved, 142 of which were included in the final analysis, prevention and control of CLABSI in recent 10 years has achieved remar-kable results (OR=0.26, 95%CI: 0.24-0.29), about 68.53% of CLABSI can be prevented. There is no heterogeneity among studies, a total of 43 614 patients are involved, far exceeding the cut off points of trial sequential analysis. Conclusion Prevention and control of CLABSI in China has achieved remarkable results in recent ten years, there is no need to carry out more trial to prove it, follow-up quality improvement study can be carried out according to the 2021 guidelines, further reduce the rate of vascular catheter-associated infection.