CAJ | 학술논문

目的：系统评价我国新生儿呼吸机相关并发症特征及影响因素，为科学制订管理策略提供依据。方法：系统检索中国生物医学文献数据库（CBM）、中国学术期刊网络出版总库（CNKI）、维普中文科技期刊全文数据库（VIP）、万方数据库、Pubmed及Embase数据库中相关文献，采用NOS标准评价质量，定性及Meta分析提取数据。结果：Meta分析显示死亡患者的构成比在体重≤1.5 kg组高于>1.5 kg组，上机≥7 d组高于<7 d组（P＜0.05）；早产儿组呼吸机相关肺炎（VAP）、颅内出血、败血症、肺出血及气胸患者的构成比高于足月儿组（P＜0.05）；体重≤1.5 kg组并发VAP、败血症、肺出血、颅内出血及气胸患者的构成比高于>1.5 kg组（P＜0.05）。上机≥7 d组并发VAP、败血症、颅内出血、肺出血及气胸患者构成比高于<7 d组（P＜0.05）。结论：新生儿呼吸机相关并发症复杂多样，为患儿的重要死亡因素，研究证实VAP、败血症、肺出血、气胸及颅内出血等为重点监测指标；胎龄，低体重及上机时间均为呼吸机相关并发症的重要危险因素，其详细机制尚不清楚，尚需深入研究。
목적：계통평개아국신생인호흡궤상관병발증특정급영향인소，위과학제정관리책략제공의거。방법：계통검색중국생물의학문헌수거고（CBM）、중국학술기간망락출판총고（CNKI）、유보중문과기기간전문수거고（VIP）、만방수거고、Pubmed급Embase수거고중상관문헌，채용NOS표준평개질량，정성급Meta분석제취수거。결과：Meta분석현시사망환자적구성비재체중≤1.5 kg조고우>1.5 kg조，상궤≥7 d조고우<7 d조（P＜0.05）；조산인조호흡궤상관폐염（VAP）、로내출혈、패혈증、폐출혈급기흉환자적구성비고우족월인조（P＜0.05）；체중≤1.5 kg조병발VAP、패혈증、폐출혈、로내출혈급기흉환자적구성비고우>1.5 kg조（P＜0.05）。상궤≥7 d조병발VAP、패혈증、로내출혈、폐출혈급기흉환자구성비고우<7 d조（P＜0.05）。결론：신생인호흡궤상관병발증복잡다양，위환인적중요사망인소，연구증실VAP、패혈증、폐출혈、기흉급로내출혈등위중점감측지표；태령，저체중급상궤시간균위호흡궤상관병발증적중요위험인소，기상세궤제상불청초，상수심입연구。
Objective:To systematically evaluate ventilator-associated complications and the influencing factors in order to provide ba-sis for formulating scientific management strategies.Methods:China biomedical literature database(CBM),China national knowledge infra-structure(CNKI),VIP,Wanfang database,Pubmed and Embase database were systematically retrieved,the quality and the data were eval-uated and analyzed by using NOS and qualitative and Meta-analysis.Results:The Meta-analysis showed that the constituent ratio of death cases was higher in those whose body weight was less than 1.5 kg than those more than 1.5 kg(P<0.05);the constituent ratio of the incidence of ventilator-associated pneumonia(VAP),intracranial hemorrhage,sepsis,pulmonary hemorrhage and pneumothorax was higher in premature infants than that of full-term infants(P<0.05).Conclusion:The ventilator-associated complications in neonates are complex and diverse,and VAP,sepsis,pulmonary hemorrhage,pneumothorax and intracranial hemorrhage are the key monitoring indica-tors.The gestational age,low birth weight and duration of ventilation are the main risk factors of ventilator-associated complications.