有创机械通气发生早发性呼吸机相关性肺炎的临床分析

目的 探讨有创机械通气出现早发性呼吸机相关性肺炎(VAP)的临床特点。方法 监测和分析98例非肺部感染性疾病行气管插管或气管切开术进行机械通气的患者发生早发性VAP的相关因素、呼吸道感染菌群的特点及其耐药特性。结果 98例患者中，有31例在术后4d内发生VAP(VAP组)，占31．6％，其气道分泌物培养获得致病菌42株，均为多重耐药菌。VAP组患者的年龄、有慢性阻塞性肺疾病(COPD)史者、术前抗生素的使用率均高于无VAP组。结论 早发性VAP的出现与患者的年龄、COPD史有一定关系，术前抗生素的使用可能与致病菌的高度耐药有关。

Clinical analysis of early-onset ventilator-associated pneumonia caused by invasive mechanical ventilation

Objective To explore ventilator associated pneumonia (VAP) in patients with invasive mechanical ventilation. Methods To observe the correlative factors, distribution and antibacterial resistance of pathogens from the patients with early onset VAP of invasive ventilation. Results The results showed that 31 patients (31.6%) were suffered from VAP among the 98 patients four days after the invasive ventilation. 42 strains were isolated from 31 VAP cases, with predominance of multi resistance bacilli. The rate with history of chronic obstructive pulmonary disease (COPD), older age and use of more antibiotics were higher in patients with early onset VAP than those without. Conclusion Early onset VAP usually occurs in those with history of COPD, older age and use of broad spectrum antibiotics.