ICU患者中心静脉导管相关血流感染风险预测工具的系统评价

doi:10.3761/j.issn.0254-1769.2025.09.018

摘要/Abstract

摘要：

目的系统检索和评价国内外ICU患者中心静脉导管相关血流感染风险预测工具，为临床医护人员选择或开发合适的风险预测工具提供参考。方法检索PubMed、Embase、Web of Science、Cochrane Library、CINAHL、中国知网、万方数据库、维普数据库和中国生物医学文献数据库中有关ICU患者中心静脉导管相关血流感染风险预测工具的研究，检索时限为建库至2024年5月。由2名研究者独立筛选文献、提取数据，并对纳入文献进行偏倚风险评价、适用性评价。结果最终纳入11项研究，涉及9个风险预测模型和2个风险评估量表，其中9项研究在工具开发后验证了工具的预测效能或信效度。结论 ICU患者中心静脉导管相关血流感染风险预测工具预测效能和适用性较好，但整体偏倚风险较高。未来可使用现有工具开展验证研究，或构建低偏倚风险、高适用性的风险预测工具。

关键词: 重症监护病房, 中心静脉导管, 血流感染, 风险评估, 预测模型, 系统评价, 护理

Abstract:

Objective To systematically analyze the risk prediction instruments for central line associated bloodstream infection in ICU patients，with a view to provide references for clinical practice. Methods The PubMed，Embase，Web of Science，Cochrane Library，CINAHL，CNKI，WanFang，VIP and CBM Database were searched from inception to May 2024. There were 2 researchers who independently screened the literature，extracted the information，and assessed the risk of bias and applicability of the included literature. Results 11 studies were involved in the final review，involving 9 risk prediction models and 2 risk assessment tables，9 of which validated the predictive efficacy or reliability and validity of the instruments. Conclusion The risk prediction instruments for central line associated bloodstream infection in ICU patients had good predictive efficacy and applicability，but the overall risk of bias was high. It is recommended that further examination，verification the existing instruments should be conducted，or to build a prediction instrument with low risk of bias and high applicability.

Key words: Intensive Care Units, Central Venous Catheter, Bloodstream Infection, Risk Assessment, Prediction Model, Systematic Review, Nursing Care

周淼, 陈星, 彭飞, 孙尚雪, 李阳洋. ICU患者中心静脉导管相关血流感染风险预测工具的系统评价[J]. 中华护理杂志, 2025, 60(9): 1132-1139.

ZHOU Miao, CHEN Xing, PENG Fei, SUN Shangxue, LI Yangyang. Systematic review of risk prediction instruments for central line associated bloodstream infections in ICU patients[J]. Chinese Journal of Nursing, 2025, 60(9): 1132-1139.

图/表 6

图1 PubMed检索策略

Figure 1 PubMed retrieval strategies

图2 文献筛选流程

Figure 2 Flow chart of literature selection

表1 纳入文献的基本特征（n=11）

Table 1 Characteristics of the included studies（n=11）

表2 ICU患者中心静脉导管相关血流感染风险预测模型的相关信息（n=9）

Table 2 Information of CLABSI risk prediction models for ICU patients（n=9）

表3 ICU患者中心静脉导管相关血流感染风险预测模型中重复报告排名前10的预测因子

Table 3 The top 10 predictors for repeat reporting in CLABSI risk prediction models for ICU patients

表4 ICU患者中心静脉导管相关血流感染风险预测模型偏倚风险和适用性评价（n=9）

Table 4 Bias risk and applicability evaluation of CLABSI risk prediction model for ICU patients（n=9）

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