不同体温状态对脓毒症患者预后影响的Meta分析

doi:10.3761/j.issn.2096-7446.2025.05.020

摘要/Abstract

摘要：

目的研究体温对脓毒症患者预后的影响。方法计算机检索中国生物医学文献数据库、中国知网、万方数据库、维普数据知识服务平台、PubMed、Embase、Cochrane Library中有关体温对脓毒症患者预后影响的病例对照研究、前瞻性或回顾性队列研究，检索时限为建库至2024年6月1日。由2名研究人员独立进行文献筛选、数据提取，评价纳入研究的偏倚风险后，采用RevMan 5.4.1软件进行Meta分析。结果最终纳入23篇文献，共3 516 745例患者。结果显示，发热及低体温对脓毒症患者住院病死率及28 d病死率有影响（P<0.01），对住院时长及ICU住院时长的影响尚不明确（P>0.05）。结论高热及低温都会增加脓毒症患者的住院病死率及28 d病死率。因此，在临床诊疗及护理脓毒症的过程中，需要密切观察体温变化，及时采取相应的体温控制策略，改善患者结局。

关键词: 体温, 脓毒症, 预后, Meta分析

Abstract:

Objective To investigate the effect of body temperature on prognosis in septic patients. Methods PubMed，Embase，the Cochrane Library，Web of Science，China Biomedical Literature Database，Wanfang Data Knowledge Service Platform，China National Knowledge Infrastructure，VIP database were electronically searched to collect case-control studies，prospective or retrospective cohort studies on the effect of body temperature on the prognosis of septic patients from inception of database to June 1，2024. Two reviewers performed independent literature screening，data extraction，and evaluating the risk of bias in the included studies，then performed meta-analysis by RevMan 5.4.1 software. Results 23 articles were included，with a total of 3 516 745 patients. The results showed that fever and hypothermia had significant effects on hospital mortality and 28d mortality（P<0.01），and the impact on the length of hospitalization and ICU stay was not yet clear（P>0.05）. Conclusion This meta-analysis showed that fever and hypothermia can increase the hospital mortality and 28d mortality in patients with sepsis. Therefore，during the process of clinical diagnosis and treatment and nursing，it is necessary to closely observe the change of body temperature，take the corresponding body temperature control strategies in time，and improve patient’s outcome.

Key words: Body Temperature, Sepsis, Prognosis, Meta-analysis

李季, 金静芬, 张玉萍, 成医锋, 王旭阳. 不同体温状态对脓毒症患者预后影响的Meta分析[J]. 中华急危重症护理杂志, 2025, 6(5): 616-623.

LI Ji, JIN Jingfen, ZHANG Yuping, CHENG Yifeng, WANG Xuyang. Effect of different body temperature on prognosis in septic patients：a meta-analysis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(5): 616-623.

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