CAJ | 학술논문

目的：系统分析新生儿 VAP 相关高危机械通气因素，为科学制订新生儿 VAP 的预警及预防策略提供依据。方法：计算机及手工检索 CBM、CNKI、万方、ISI、Pubmed 及 Embase 数据库中相关文献，采用 NOS 标准评价纳入研究偏倚风险、定性及 Meta分析定量结合分析研究数据。结果：纳入20个病例对照研究，NICU 新生儿3497例，VAP 1173例，3类机械通气相关因素。Me-ta 分析结果显示：再次插管、平均插管次数、反复吸痰、吸痰≥8次/ d、平均通气时间、通气﹥7 d 、通气≥4 d 和通气﹤4 d 指标差异有统计学意义（P ﹤0.01）。结论：本研究证实再次插管、反复吸痰及通气时间延长增加 VAP 风险，均为新生儿 VAP 重要高危因素及预警指标，但尚需深入研究揭示吸痰次数及通气时间与 VAP 风险的动态关系。
목적：계통분석신생인 VAP 상관고위궤계통기인소，위과학제정신생인 VAP 적예경급예방책략제공의거。방법：계산궤급수공검색 CBM、CNKI、만방、ISI、Pubmed 급 Embase 수거고중상관문헌，채용 NOS 표준평개납입연구편의풍험、정성급 Meta분석정량결합분석연구수거。결과：납입20개병례대조연구，NICU 신생인3497례，VAP 1173례，3류궤계통기상관인소。Me-ta 분석결과현시：재차삽관、평균삽관차수、반복흡담、흡담≥8차/ d、평균통기시간、통기﹥7 d 、통기≥4 d 화통기﹤4 d 지표차이유통계학의의（P ﹤0.01）。결론：본연구증실재차삽관、반복흡담급통기시간연장증가 VAP 풍험，균위신생인 VAP 중요고위인소급예경지표，단상수심입연구게시흡담차수급통기시간여 VAP 풍험적동태관계。
Objective:To systematically analyze the high risk factors of ventilator - associated pneumonia(VAP)in neonates in order to provide the basis for the scientific development of the early warning and prevention strategy of VAP. Methods:We retrieved all studies about the ventilation - related factors of VAP in neonates in CNKI,Wanfang,CBM,ISI,Pubmed and Embase and evaluated their risk of bias by Newcastle - Ottawa scale and analyzed all data by qualitative and meta - analysis. Results:20 cases were included in the control study,in-volving 3497 neonates in NICU(1173 cases of VAP)and 3 types of mechanical ventilation related factors. The results of meta - analysis showed that significant differences were found in reintubation,average intubation times,repeated suctioning,suctioning≥8times/ d,average ventilator time,the duration of ventilation ﹥ 7d,ventilation≥4d and ventilation ﹤ 4d(P ﹤ 0. 01). Conclusion:This study confirms that the reintubation and repeated suctioning can increase the risk of VAP and they are the important risk factors and early warning index. Further research is needed to reveal the dynamic relationship between sputum suction times or ventilation time and the VAP risk.