新生儿机械通气相关性肺炎危险因素探讨

目的 探讨新生儿机械通气相关性肺炎(VAP)的危险因素.方法 回顾分析我院82例行机械通气辅助治疗的新生儿发生VAP的临床情况,采用Logistic多元回归分析方法探讨新生儿发生VAP可能的危险因素.结果 Logistic多元回归分析表明有统计学意义(P＜0.05)的危险因素有胎龄(OR=6.209,95%CI=2.112～16.835)、机械通气时间(OR=5.842,95%CI=1.366～14.936)、气管内吸引次数(OR=4.764,95%CI=1.416～14.736)、再插管(OR=6.190,95%CI=1.669～16.019)、留置胃管(OR=6.794,95%CI=1.928～19.160)、应用中枢抑制剂(OR=4.297,95%CI=1.002～15.216).结论 新生儿VAP的发生是多因素的综合作用结果,出生时胎龄小、机械通气时间长、气管内吸引次数多、再插管、留置胃管、应用中枢抑制剂是新生儿发生VAP的危险因素.

Analysis of the risk factors for neonatal ventilator-associated pneumonia

Objective To explore the risk factors of ventilator-associated pneumonia(VAP)in neonatal patients.Methods A retrospective study was conducted on the 82 neonates who had ever received mechanical ventilation for more than 48 hours,non-conditional logistic regression analysis was performed to determine independent predictors for VAP.Results By logistic regression analysis,the following risk factors independently predicted VAP:gestational age(OR = 6.209,95%CI =2.112～16.835),duration of mechanical ventilation(OR =5.842,95%CI = 1.366～14.936),times of endotracheal suctioning(OR =4.764,95%CI = 1.416～14.736),re-intubation(OR = 6.190,95%CI = 1.669～16.019),gastric tubes retention(OR =6.794,95%CI = 1.928～19.160),treatment with CNS suppressant(OR = 4.297,95%CI = 1.002～15.216).Conclusion The neonatal VAP occoured for multiple facors,the rsik factors include gestational age,duration of mechanical ventilation,endotracheal suctioning,re-intubadon,gastric tubes retention and treatment with CNS suppressant.