Zhao Jing, Zhang Liqin, Zhang Dongquan, Tian Jinhui, He Tianpeng, Gong Dong, Yuan Yuan
Department of Critical Care Medicine, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China (Zhao J, Zhang LQ, Zhang DQ, Yuan Y); Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China (Zhao J, He TP, Gong D); Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, Gansu, China (Tian JH). Corresponding author: Yuan Yuan, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018 Nov;30(11):1029-1035. doi: 10.3760/cma.j.issn.2095-4352.2018.011.004.
OBJECTIVE: To survey the distribution pattern and subject domain knowledge of the literatures about ventilator-associated pneumonia (VAP). METHODS: Literatures about VAP published until December 2017 were identified in SinoMed database for statistics and analysis. The information of author, organization and province was extracted by BICOMS software for generating co-occurrence matrix, at the same time, the topic words were cluster analyzed by Gcluto software to generate topical visual surface maps and visualization matrices, and the current research hotspots were analyzed. NetDraw from Ucinet 6.0 software was used to arrange the relationship among topic words according to the centrality, and the social network diagrams of authors, authors' provinces and institutions were draw to analyze the current status of VAP research cooperation. RESULTS: 4 851 VAP-related literatures were retrieved preliminarily, and 43 were excluded from abstracts, news reports, information and missing literatures. Finally, a total of 4 808 articles were enrolled in the visual analysis. From 2001 to 2004, the number of VAP-related literatures published was less than 10. Since 2009, the number of VAP documents had increased steadily, from 2010 to 2017, the peak period of publications reached 91.7% (4 411/4 808). According to the analysis of the amount of publications, the top three of 34 provincial administrative regions that published VAP-related literature in China were Guangdong Province (n = 628), Jiangsu Province (n = 478) and Zhejiang Province (n = 404), the number of hospitals issued by the First Affiliated Hospital of Chongqing Medical University was the largest (n = 20); there was only one journal with more than 100 articles, and there were 154 journals with only one article, accounting for 34.8% of the total number of journals. A total of 9 921 authors participated in the VAP-related literature writing, the number of high-yielding authors was not large, and the institution could not establish an effective social network diagram, suggesting that communication and cooperation should be strengthened in hospitals and outside hospitals. The results of the topic words social network analysis showed that the VAP research field was centered around the core of "mechanical ventilation", "intensive care unit (ICU)", "risk factor analysis", "nursing", "etiological analysis", "preventive measures" and "pathogens". The current research hotspots were at the edge of the network map, such as "drug sensitivity analysis", "Acinetobacter baumannii", "bronohoalveolar lavage (BAL)" and "acute exacerbation of chronic obstructive pulmonary disease (AECOPD)". By clustering 80 high-frequency topic words, at present, VAP research hotspots were mainly focus on five topics: obstructive pulmonary disease, especially in acute exacerbation, was prone to VAP; concerned about newborns and children's VAP; types, drug resistance and selection of antimicrobial agents for VAP pathogens in ICU; clinical efficacy and prognosis of VAP through preventive measures, pulmonary supportive care and comprehensive care interventions; oral care and airway management during mechanical ventilation was also the key aspect of the treatment of VAP. CONCLUSIONS: In recent years, the academics had attached great importance to the study of VAP, the number of publications had reached a historical peak, and the research direction was diverse. However, it was necessary to strengthen cooperation among research institutes, collect and count epidemiological data, improve and expand the research quality and scale of clinical diagnosis, nurse, prevention, pathogen distribution and drug resistance analysis.
目的:调查呼吸机相关性肺炎(VAP)相关文献的分布格局及主题领域知识。 方法:在《中国生物医学文献数据库》中检索截至2017年12月发表的VAP相关文献进行统计分析。利用BICOMS软件提取作者、机构及省份信息生成共现矩阵,同时运用Gcluto软件对主题词进行聚类分析生成主题可视化图谱及可视化矩阵,分析当前研究热点。使用Ucinet 6.0软件中的NetDraw依据中心性排列主题词之间的关系,绘制作者、作者所在省份及机构的社会网络图,分析VAP研究合作现状。 结果:初步检索到4851篇VAP相关文献,排除摘要、新闻报道、资讯及缺失文献43篇。最终纳入可视化分析的文献共4808篇。2001 - 2004年,VAP相关文献发表数量不足10篇。自2009年起,VAP文献数量稳步增长,2010 - 2017年为发表高峰期,占91.7%(4411/4808)。根据发文量分析,我国发表VAP相关文献的34个省级行政区中,发文量排名前三的是广东省(n = 628)、江苏省(n = 478)和浙江省(n = 404),重庆医科大学附属第一医院发文数量最多(n = 20);仅有1种期刊发文量超过100篇,有154种期刊仅发文1篇,占期刊总数的34.8%。共有9921位作者参与VAP相关文献撰写,高产作者数量不多,机构间未能建立有效的社会网络图,提示医院内外应加强交流合作。主题词社会网络分析结果显示,VAP研究领域围绕“机械通气”“重症监护病房(ICU)”“危险因素分析”“护理”“病因分析”“预防措施”及“病原菌”等核心展开。当前研究热点位于网络图边缘,如“药敏分析”“鲍曼不动杆菌”“支气管肺泡灌洗(BAL)”及“慢性阻塞性肺疾病急性加重(AECOPD)”等。通过对80个高频主题词聚类分析,目前VAP研究热点主要集中在五个主题:阻塞性肺疾病尤其是急性加重时易发生VAP;关注新生儿及儿童VAP;ICU中VAP病原菌的种类、耐药性及抗菌药物选择;通过预防措施、肺部支持治疗及综合护理干预对VAP的临床疗效及预后;机械通气期间的口腔护理及气道管理也是VAP治疗的关键环节。 结论:近年来,学术界高度重视VAP研究,发文数量达历史高峰,研究方向多样。然而,需加强研究机构间合作,收集统计流行病学数据,提高并扩大临床诊断、护理、预防、病原菌分布及耐药性分析等方面的研究质量与规模。
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