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目的系统评价肥胖对ICU机械通气患者预后的影响。方法检索Pub Med、Embase、The Cochrane Library、中国期刊全文数据库(CNKI)、万方数据库、中国科技期刊数据库(VIP)、中国生物医学文献数据库(CBM),纳入观察体质量指数(BMI)对ICU成年机械通气患者预后影响的病例对照研究和队列研究。对纳入文献进行偏倚风险评估和Meta分析。结果共纳入19篇文献,26 920例患者。Meta分析结果显示,肥胖组比非肥胖组患者的机械通气时间明显延长(0.29 d,95%CI 0.08~0.51,P=0.007),住院病死率(RR=0.85,95%CI 0.79~0.92,P<0.01)和长期病死率(RR=0.87,95%CI 0.81~0.93,P<0.01)明显降低。而次要结局指标如住院时间、并发症发生情况比较无统计学差异。结论 ICU肥胖患者需要更长的机械通气时间,有较低的住院病死率和长期病死率。
Objective To evaluate the effect of obesity on the prognosis of ICU patients with mechanical ventilation. Methods PubMed, Embase, The Cochrane Library, Chinese Journal Full-text Database (CNKI), Wanfang Database, China Science and Technology Database (VIP), China Biomedical Literature Database (CBM) Case-control study and cohort study of the prognosis of adult ventilator patients. Biased risk assessment and meta-analysis of included literature. Results A total of 19 articles were included and 26 920 patients were included. Meta-analysis showed that the duration of mechanical ventilation was significantly longer in obese patients than in non-obese patients (0.29 d, 95% CI 0.08-0.51, P = 0.007), and hospital mortality (RR = 0.85, 95% CI 0.79-0.92, P <0.01) and long-term mortality (RR = 0.87, 95% CI 0.81-0.93, P <0.01). The secondary outcome measures such as hospital stay, complication incidence no significant difference. Conclusion Obese patients with ICU need longer mechanical ventilation, lower hospital mortality and long-term mortality.