呼吸机相关肺炎危险因素临床研究

目的探讨影响呼吸机相关肺炎（VAP）的危险因素。方法对2004年5月至2009年11月入住重症监护病房采用机械通气治疗的160例患者进行回顾性队列研究，将患者按相关危险因素自然分组，比较VAP发病率，并进行多因素非条件Logistic回归分析。结果160例行机械通气治疗的患者中有77例发生VAP，发病率为48．1％。机械通气≥5d、仰卧位、应用抑制胃酸分泌药、进行侵入性操作、应用糖皮质激素、白蛋白〈30g／L、多器官功能障碍综合征（MODS）与各自对照组比较，其机会比（OR）及OR值95％可信区间比较差异有统计学意义，是影响VAP发生的危险因素。结论机械通气较长时间、仰卧位、应用抑制胃酸分泌药（制酸剂）、侵入性操作、应用糖皮质激素、白蛋白〈30s／L、发生MODS是影响VAP发生的主要危险因素。

Emergency management of risk factors for ventilator - associated pneumonia

Objective To study the risk factors forventilator- associated pneumonia（VAP）. Methods A retrospective cohort study was conducted in 160 patients who had received mechanical ventila- tion in intensivecare unit from May 2004 to November 2009. Chi - square test and logistic regression were a- dopted to ananlyze the VAP incidence rate and related risk factors, respectively. Results The diagnosis of VAP was established in 77 cases with the incidence rate of 48.1%. The duration of mechanical ventilation I〉 5 days, supine posture, gastric acid secretion inhibitortherapy, invasive operation, corticosteroid use,albumen 〈30 g/L, and multiple organdysfunction syndrome（MODS）were the risk factors for VAP. Conclusions The duration of mechanical ventilations〉5 days, supine posture, gastric acidsecretion inhibitor therapy, invasive operation, cortlcosteroid use, albumen 〈30 g/L, and MODS are main risk factors for VAP.