早产儿呼吸机相关性肺炎危险因素及对策研究

目的探讨早产儿呼吸机相关性肺炎（VAP）发病危险因素和干预措施。方法采用回顾性病例对照研究,将机械通气时间≥48 h的189例早产儿根据是否发生VAP而分为病例组和对照组,进行单因素和多因素分析VAP发病的危险因素。结果早产儿VAP发生率为28.6%;病原菌以革兰阴性菌为主,占66.7%;多因素结果显示,出生体重越轻（OR=1.449）、气管插管次数越多（OR=1.690）、气管内吸引≥6次/d（OR=3.099）、机械通气时间≥5 d（OR=3.831）是早产儿VAP发生的危险因素。结论进行机械通气的早产儿具有较高的VAP发生率,VAP发生的因素较多,需采取综合预防措施来防止VAP的发生。

Study on risk factors of premature ventilator-associated pneumonia and its countermeasures

Objective]To explore the risk factors of premature ventilator-associated pneumonia（ VAP） and its intervention measures.Methods]With retrospective case-control study method,189 prematures who had received mechanical ventilation（ MV） for more than 48 hours were divided into the case group and the control group according to the VAP standard. The single factor analysis and multiple factors non-conditional logistic regression method were used to analyze the risk factors.Results]The incidence rate of VAP among prematures was 28. 6%,and 66. 7% of pathogens was gram-negative bacteria. Multivariate factors analysis indicated that low birth weight（ OR = 1. 449）,repeatedly tracheal intubation（ OR = 1. 690）,endotracheal suction over 6 times daily（ OR =3.099）,and MV over 5 days（ OR =3.831） were the risk factors of premature VAP.Conclusion]The incidence rate of VAP among prematures undergoing MV is high,and there are many risk factors. So it is necessary to carry out comprehensive prevention measures to prevent the VAP.