ISSN 2096-7446 CN 10-1655/R
主管:中国科学技术协会
主办:中华护理学会

中华急危重症护理杂志 ›› 2023, Vol. 4 ›› Issue (9): 792-798.doi: 10.3761/j.issn.2096-7446.2023.09.004

• 重症患者安全管理专题 • 上一篇    下一篇

成人ICU患者腹内高压危险因素的Meta分析

李志茹 王华芬 卢芳燕 郑力 董丽 鲍瑞洁   

  • 出版日期:2023-09-10 发布日期:2023-09-15

Risk factors of intra-abdominal hypertension in adult ICU patients:a Meta-analysis

LI Zhiru,WANG Huafen,LU Fangyan,ZHENG Li,DONG Li,BAO Ruijie   

  • Online:2023-09-10 Published:2023-09-15

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3 250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。

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

Abstract: 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 3 250 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),APACHEⅡ Score (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 APACHEⅡ Score,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.

Key words: Intensive Care Units, Intra-abdominal Hypertension, Risk Factors, Meta-Analysis, Evidence- Based Nursing