| 外科重症监护室呼吸机相关性肺炎的高危因素及病原学特点 |
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| 引用本文： | 万晓红,黄青青,万林骏,苏美仙. 外科重症监护室呼吸机相关性肺炎的高危因素及病原学特点[J]. 中国感染控制杂志, 2008, 7(2): 106-110 |
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| 作者姓名： | 万晓红 黄青青 万林骏 苏美仙 |
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| 作者单位： | 昆明医学院第二附属医院,云南,昆明,650101 |
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| 摘 要： | 目的探讨某院外科重症监护室（SICU）呼吸机相关性肺炎（VAP）的高危因素和病原学特点。方法对该院2004年1月—2007年2月住SICU行机械通气的患者进行前瞻性队列研究,对其中机械通气时间≥48h的患者资料进行统计分析。结果共有125例患者机械通气时间≥48h,符合VAP诊断者59例（47.20%）。机械通气时间延长、年龄≥60岁、留置胃管、鼻饲、机械通气前2周内使用抗菌药物、近期或正在使用肾上腺糖皮质激素、进行肠道手术各组分别与无上述因素组比较,VAP发病率明显增高（P〈0.05）。VAP组的APACHEⅡ评分、总机械通气时间、住SICU时间、病死率均明显高于无VAP组（P〈0.05）。病原菌以革兰阴性（G^-）菌为主（51.82%）,其次为革兰阳性（G＋）菌（31.82%）、真菌（16.36%）;绝大部分病原菌呈现多重耐药性。结论VAP的发生与多种临床因素相关;病原菌以G^-菌为主,多呈现多重耐药性;VAP的发生严重影响患者预后。
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| 关 键 词： | 呼吸机相关性肺炎 重症监护室 病原学 危险因素 微生物敏感性试验 |
| 文章编号： | 1671-9638(2008)02-0106-05 |
| 修稿时间： | 2007-09-17 |
High risk factors and pathogenic characteristics of ventilator-associated pneumonia in patients in surgical intensive care unit |
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| WAN Xiao-hong,HUANG Qing-qing,WAN Lin-jun,SU Mei-xian. High risk factors and pathogenic characteristics of ventilator-associated pneumonia in patients in surgical intensive care unit[J]. Chinese Journal of Infection Control, 2008, 7(2): 106-110 |
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| Authors: | WAN Xiao-hong HUANG Qing-qing WAN Lin-jun SU Mei-xian |
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| Affiliation: | (The Second Affiliated Hospital, Kunming Medical College ,Kunming 650101 ,China) |
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| Abstract: | Objective To evaluate the high risk factors and pathogenic characteristics of ventilator-associated pneumonia（VAP） in patients in surgical intensive care unit（SICU）. Methods A prospective cohort study was made on patients with mechanical ventilation, patients were hospitalized between January 2004 and February 2007, the medical data of patients who were given mechanical ventilation ≥48 hours were analyzed statistically. Results One hundred and twenty-five patients received mechanical ventilation ≥48 hours, 59 cases（47. 20%） developed VAP. Patients with prolonged mechanical ventilation, age≥60,nasal feeding, antimicrobial application 2 weeks before mechanical ventilation, recent application of glucocorticoid and intestinal tract operations respectively had obviously higher occurrence of VAP compared with patients without the above factors（P〈0. 05）. In VAP group, the A- PACHE Ⅱ score,total ventilation time, the length of stay in SICU,mortality were obviously higher than those in non-VAP group （P〈0. 05）. The main pathogens of VAP was gram-negative bacteria（51.82 %）, followed by grampositive bacteria（31. 82%） and fungi（16. 36%） ;most pathogens were multiple resistant strains. Conclusion The occurrence of VAP is related to multiple clinical factors; the main pathogens of VAP is multiple drug-resistant gramnegative bacteria. The occurrence of VAP can severely affect the prognosis of patients. |
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| Keywords: | ventilator-associated pneumonia intensive care unit etiology risk factors antimicrobial susceptibility test |
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