摘要
目的通过Meta分析明确成人ICU患者发生腹内高压的危险因素。方法计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、Cochrane Library、PubMed、Web of Science、Embase数据库,从建库至2022年12月关于成人ICU患者发生腹内高压危险因素的文献,由2名评价人员按照标准独立筛选文献、提取资料、评价文献质量。采用RevMan 5.4软件对资料进行Meta分析。结果共纳入17篇文献,总计3250例成人ICU患者,有统计学意义的危险因素包括BMI(MD=3.09)、24 h液体输入量(MD=0.98)、机械通气(OR=3.40)、PaO2/FiO2(MD=-17.18)、急性生理与慢性健康状况评分(MD=4.04)、脓毒症(OR=2.42)、肠梗阻(OR=11.67)、腹部手术(OR=2.10)。结论BMI越高、24 h液体输入量越大、急性生理与慢性健康状况评分越高、PaO2/FiO2越低、接受机械通气、合并脓毒症、肠梗阻、腹部手术史的成人ICU患者,发生腹内高压的风险越高。医护人员应动态评估和监测成人ICU患者的腹内压情况,采取针对性、个体化干预措施预防腹内高压的发生。
Objective To identify the risk factors of intra-abdominal hypertension among adult ICU patients by meta-analysis.Methods We searched databases including CNKI,Wanfang Data,VIP,CBM,Cochrane Library,PubMed,Web of Science and Embase from inception to December 2022,to collect studies on risk factors for intra-abdominal hypertension of adult ICU patients.2 reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data,and assessed the quality of included studies.Meta-analysis was conducted by RevMan 5.4.Results A total of 17 pieces of the literature involving 3250 adult ICU patients were included.The statistically risk factors were BMI(MD=3.09),24 h fluid input(MD=0.98),mechanical ventilation(OR=3.40),PaO2/FiO2(MD=-17.18),APACHEⅡScore(MD=4.04),sepsis(OR=2.42),intestinal obstruction(OR=11.67),abdominal surgery(OR=2.10).Conclusion Higher BMI,larger 24 h fluid input,higher APACHEⅡScore,lower PaO2/FiO2,mechanical ventilation,sepsis,intestinal obstruction and abdominal surgery were independent predictors for intra-abdominal hypertension in adult ICU patients.Medical staff should dynamically assess the intra-abdominal pressure and take targeted and individualized interventions to prevent the occurrence of intra-abdominal hypertension.
作者
李志茹
王华芬
卢芳燕
郑力
董丽
鲍瑞洁
LI Zhiru;WANG Huafen;LU Fangyan;ZHENG Li;DONG Li;BAO Ruijie
出处
《中华急危重症护理杂志》
CSCD
2023年第9期792-798,共7页
Chinese Journal of Emergency and Critical Care Nursing
基金
浙江省基础公益研究计划项目(LTGY23H030004)。
关键词
重症监护病房
腹内高压
危险因素
META分析
循证护理学
Intensive Care Units
Intra-abdominal Hypertension
Risk Factors
Meta-Analysis
Evidence-Based Nursing
作者简介
通信作者:王华芬,E-mail:2185015@zju.edu.cn;李志茹:女,本科(硕士在读),护士,E-mail:22118779@zju.edu.cn。
