影响新生儿机械通气相关性肺炎发生的多因素分析

机械通气是新生儿科重要的抢救手段之一,而伴随的机械通气相关性肺炎(ventilator association pneumonia,VAP)是临床常见的棘手问题,它不仅增加了治疗难度、住院治疗费用,同时也对新生儿预后产生不良影响。因此,VAP一直是新生儿科医务工作者始终关注的重点,深入分析影响新生儿V

Multiple factors analysis of inducing neonatal ventilator association pneumonia

Objective:To explore the factors of inducing the neonatal ventilator association pneumonia(VAP).Methods:102 neonates with ventilator association pneumonia from June 2004 to May 2006 in Children's Hospital of Chongqing University of Medical Science were analyzed retrospectively.Results:The gestational age were (35.49±3.61)weeks in VAP group and(37.04±4.57) weeks in non VAP group(t=14.22 ,P<0.01). The birth weight were(2 517.33±540.57)g in VAP group and(3 122±734.26)g in non VAP group(t=21.43 ,P<0.001) .The mechanical ventilation time were (149.63±21.3)hours, while they were (88.79±15.82)hours in non VAP group(t=19.53 ,P<0.01).The platelet were (87.28±44.89)×109/L in VAP group and(152.69±60.12)×109/L in non VAP group(t=19.53 ,P<0.01).The incidence of pulmonary hemorrhage,severe asphyxia and severe hypoxic ischemic encephalopathy(HIE) were 18.9%(7/37),40.5%(15/37) and 32.4%(12/37) in VAP group,while 6.1%(4/65),20%(13/65) and 15.4%(10/65) in non VAP group respectively(P<0.05).Conclusion:Multiple factors can induce neonatal ventilator association pneumonia which are the small gestational age, low birth weight,long mechanical ventilation time, low platelet,combined or complicated pulmonary,serve asphyxia and serve hypoxia is chemic encephalopathy.