慢性阻塞性肺疾病急性加重期患者并发呼吸机相关性肺炎危险因素分析

目的:探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者并发呼吸机相关性肺炎(VAP)的危险因素,为AECOPD患者的临床治疗提供参考。方法:回顾性分析104例AECOPD患者的临床资料,包括年龄、性别、体质量指数、肠内营养支持或全静脉营养支持、是否应用抑酸药、是否合并基础疾病、呼吸机通气时间与VAP发生的关系。结果:全静脉营养支持和合并基础疾病均可增加VAP的发生率(P<0.05和P<0.01)。患者性别、年龄、体质量指数、是否应用抑酸药和呼吸机通气时间的VAP发生率差异均无统计学意义(P>0.05)。logistic回归分析结果表明,全静脉营养支持及合并基础疾病是影响VAP发生的独立危险因素(P<0.05)。结论:AECOPD患者发生VAP的影响因素较多,应积极治疗基础疾病,早期肠内营养支持,改善患者的预后。

The risk factors analysis of acute exacerbation of chronic obstructive pulmonary disease patients complicated with ventilator-associated pneumonia

Objective:To investigate the risk factors of acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) patients complicated with ventilator-associated pneumonia ( VAP ) , and provide the basis for the clinical treatment of patients with AECOPD. Methods:The clinical data about the relationships of the occurrence of VAP and the general information ( age,gender and body mass index ) , nutrition support route ( enteral nutrition or total parenteral nutrition support ) , whether application of acid suppressive drugs,whether complicated with basic diseases, mechanical ventilation time in the 104 AECOPD patients were analyzed retrospectively. Results:The incidence of VAP was increased by total parenteral nutrition and combined with basic diseases( P<0. 05 and P<0. 01). There was no significant difference between the incidence of VAP and gender,age,body mass index,the application of acid suppressive drugs and the time of ventilator ventilation(P>0. 05). The results of logistic regression analysis were shown that the total parenteral nutrition support and combination with basic diseases were the independent risk factors for VAP (P < 0. 05). Conclusions:There are many factors affecting the incidence of VAP in AECOPD patients,the basic diseases should be treated actively, and early enteral nutrition support should be done,to improve the prognosis of patients.