呼吸机相关性肺炎的危险因素及病原菌分析

目的探讨呼吸机相关性肺炎（VAP）的危险因素及病原菌的构成。方法回顾性收集重症监护室（ICU）收住的118例机械通气患者中VAP发生的危险因素及病原菌培养结果进行调查分析。结果VAP的发病率为44．9％，其中年龄、机械通气时间、意识障碍、气管切开、抗生素的联合应用是医院获得性肺炎的重要危险因素，53例VAP以G-菌感染为主（68．2％），其次为G-菌（25．9％）和真菌（5．9％），病原菌存在多重耐药性。结论多种临床因素与VAP的发病有关；VAP病原菌以G-菌为主，耐药率高；VAP的发生将严重影响患者的预后。

Research on risk factors and pathogens of ventilator associated pneumonia

Objective To study the risk factors and pathogenic characteristics of ventilator associated pneumonia(YAP). Methods Risk factors of VAP,pathogens and drug resistance in 118 patients in ICU were analyzed retrospectively. Results The incidence of VAP was 44.9％, and age, the mechanical ventilation time, state of consciousness,tracheotomy,the antibiotic combination are risk factors of incidence of VAP. 53cases of VAP(68.2％ )were infected by Gram negative bacilli,25.9％ were by Gram positive cocci,and 5.9％ were by fungi. Drug resistance was observed obviously. Conclusion The occurrence of VAP was related with multiple factors. The gram negative bacteria are the major pathogens of VAP, and the rate of drug resistance was high. The occurrence of VAP could severely affect patients' prognosis.