【摘要】 目的 通过Meta分析确定高血压脑出血(hypertensive intracerebral hemorrhage, HICH)患者术后合并肺部感染的危险因素。方法 计算机检索PubMed、Embase、Web of Science、Cochrane Library、CNKI、VIP、CBM和WanFang等国内外数据库，收集有关HICH患者术后肺部感染危险因素的病例-对照研究与队列研究。两名研究者独立进行文献筛选、资料提取和质量评价，采用Stata 15.0软件进行Meta分析。结果 共纳入13篇文献，包括HICH患者2 344例。结果显示：年龄≥65岁[OR=3.86,95%CI(3.03,4.92),P<0.001]、糖尿病[OR=3.13,95%CI(2.04,4.79),P<0.001]、低蛋白血症[OR=3.43,95%CI(2.50,4.70),P<0.001]、吸烟史[OR=2.17,95%CI(1.35,3.47),P=0.001]、呼吸系统疾病[OR=3.67,95%CI(1.75,7.69),P=0.001]、GCS评分<8分[OR=2.31,95%CI(1.05,5.12),P=0.038]、意识障碍[OR=3.08,95%CI(1.34,7.09),P=0.008]、脑出血量≥50 mL[OR=1.62,95%CI(1.27,2.06),P<0.001]、气管切开[OR=3.85,95%CI(1.37,10.85),P=0.011]、机械通气>24 h[OR=4.65,95%CI(3.07,7.06),P<0.001]、机械通气≥5 d[OR=4.66,95%CI(2.46,8.83),P<0.001]、气管插管>1 d[OR=2.98,95%CI(1.98,4.50),P<0.001]、使用抗菌药物[OR=4.62,95%CI(3.73,5.74),P<0.001]是HICH患者术后合并肺部感染的危险因素。结论 HICH患者术后合并肺部感染危险因素较多，医务人员在临床治疗与护理过程中，对可控因素采取针对性的干预措施，降低肺部感染率，提高患者预后；但部分危险因素纳入文献数量较少，影响研究结果的全面性与代表性，建议今后多开展大样本、前瞻性研究，深入探讨HICH患者术后肺部感染的危险因素。更多还原

【Abstract】 Objective To determine the risk factors for postoperative pulmonary infection in patients with hypertensive intracerebral hemorrhage(HICH) through a meta-analysis.Methods Databases including PubMed, Embase, Web of Science, Cochrane Library, CNKI,VIP,CBM,and WanFang were searched for case-control and cohort studies on risk factors for postoperative pulmonary infection in HICH patients.Two researchers independently screened the literature, extracted data and assessed quality followed by meta-analysis using Stata 15.0 software.Results A total of 13 publications were included, comprising 2344 patients with HICH.The results indicated that age ≥65-year-old [OR=3.86,95%CI(3.03,4.92),P<0.001],diabetes [OR=3.13,95%CI(2.04,4.79),P<0.001],hypoproteinemia [OR=3.43,95%CI(2.50,4.70),P<0.001],smoking history [OR=2.17,95%CI(1.35,3.47),P=0.001],respiratory disease [OR=3.67,95%CI(1.75,7.69),P=0.001],GCS score<8 [OR=2.31,95%CI(1.05,5.12),P=0.038],disturbance of consciousness [OR=3.08,95%CI(1.34,7.09),P=0.008],hematoma volume≥50 mL [OR=1.62,95%CI(1.27,2.06),P<0.001],tracheotomy [OR=3.85,95%CI(1.37,10.85),P=0.011],mechanical ventilation>24 h [OR=4.65,95%CI(3.07,7.06),P<0.001],mechanical ventilation≥5 d [OR= 4.66,95%CI(2.46,8.83),P<0.001],tracheal intubation>1 d [OR=2.98,95%CI(1.98,4.50),P<0.001],use of antimicrobial agents [OR=4.62,95%CI(3.73,5.74),P<0.001] were risk factors for postoperative pulmonary infection in patients with HICH.Conclusion There are numerous risk factors for postoperative lung infection in individuals with HICH.Medical staff should implement targeted interventions for controllable factors during clinical therapy and nursing to reduce the incidence of pulmonary infection and improve patients’ prognoses.However, several risk factors were included in fewer literatures, reducing the study results’ comprehensiveness and representativeness.More large-scale and prospective studies should be undertaken in the future to better understand the risk factors of post-operative lung infection in HICH patients.更多还原