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神经内、外科呼吸机相关性肺炎预防控制的研究
引用本文:廖映玲,李小珍,张代惠,韩艳萍,许长琼.神经内、外科呼吸机相关性肺炎预防控制的研究[J].海南医学院学报,2008,14(4).
作者姓名:廖映玲  李小珍  张代惠  韩艳萍  许长琼
作者单位:深圳市第二人民医院,广东,深圳,518035
摘    要:目的:了解神经内、外科病房呼吸机相关性肺炎(VAP)的临床相关因素和病原菌特点,提出相应的控制措施,降低神经内、外科呼吸机相关性肺炎的发生率。方法:以2004年1月~2006年12月神经内、外科收治的270例使用呼吸机患者为对象,对98例VAP患者的临床资料进行回顾性调查并统计分析。结果:270例使用呼吸机患者中,98例发生了VAP,172例未发生VAP,VAP发生率为36.30%。共分离出124株病原菌,以G-杆菌为主69株(55.65%),其次为真菌30株(24.19%)、G+球菌25株(20.16%),对多种抗生素存在不同程度的耐药;医院感染的危险因素为年长、住院时间长、大量使用抗生素、严重的基础疾病和侵入性操作等。结论:充分认识VAP的危险因素,采取防控措施,以降低VAP的发病率和病死率。

关 键 词:通气机  机械  肺炎  细菌感染  真菌

Study on the prevention and treatment of ventilator-associated pneumonia in departments of neurology and neurosurgery
LIAO Ying-ling,LI Xiao-zhen,ZHANG Dai-hui,HAN Yan-ping,XUE Chang-qiong.Study on the prevention and treatment of ventilator-associated pneumonia in departments of neurology and neurosurgery[J].Journal of Hainan Medical College,2008,14(4).
Authors:LIAO Ying-ling  LI Xiao-zhen  ZHANG Dai-hui  HAN Yan-ping  XUE Chang-qiong
Abstract:Objective:To investigate the associated factors and characteristics of causative bacteria of ventilator-associated pneumonia(VAP) in departments of neurology and neurosurgery,proposal relative control measures,reduce incidence of VAP.Methods:Data of 98 patients with VAP derived from the 270 cases using ventilator in departments of neurology and neurosurgery from January 2004 to December 2006 were studied retrospectively and analyzed with statistics.Results:Of 270 cases using ventilators,98 cases had VAP,172 cases spared VAP,the incidence of VAP was 36.3%.124 strains of germs were isolated,including Gram-negative bacilli bacteria 69 strains(55.65%),Fungi 30 strains(24.19%),Gram-positive bacteria coccus 25 strains(20.16%).Drug resistance to many antibiotics occurred on different extents.The hospital infection associated risk factors were senior age,duration of hospitalization,the intensive use of antibiotics,severe basic diseases,invasive procedures and so on.Conclusion:Awareness of the risk factors of VAP fully and adopting proper measures of prevention and control may decrease the morbidity and mortality of VAP.
Keywords:Ventilator  mechanic  Pneumonia  Bacterial infection  Fungi
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