鲍曼不动杆菌呼吸机相关性肺炎危险因素分析

目的探讨鲍曼不动杆菌呼吸机相关性肺炎危险因素,为临床预防其发生提供参考。方法回顾2010-01～2011-12间重症医学科呼吸机相关性肺炎病例,比较鲍曼不动杆菌组(ABVAP组)与非鲍曼不动杆菌组(NABVAP组)患者的一般情况、基础疾病、机械通气时间和激素使用情况,采用单因素以及多因素统计方法,分析鲍曼不动杆菌呼吸机相关性肺炎危险因素。结果入选病例98例,其中ABVAP组29例,NABVAP组69例;单因素分析显示呼吸系统疾病(χ2=4.57,P=0.03)、糖皮质激素使用≥7 d(χ2=8.64,P=0.00)与鲍曼不动杆菌呼吸机相关性肺炎相关;多因素分析显示,糖皮质激素使用≥7 d(χ2=5.70,P=0.02)是其独立危险因素。结论临床应该采用包括缩短糖皮质激素应用时间等在内的综合措施,预防鲍曼不动杆菌呼吸机相关性肺炎的发生。

Analysis of Risk Factors for Ventilator-associated Pneumonia of Acinetobacter Baumannii

Objective To explore the risk factors for ventilator-associated pneumonia of acinetobacter baumannii,and provide a reference for its prevention.Methods Data of the hospitalized patients in Department of Critical Care Medicine were collected retrospectively from January 2010 to December 2011,who had diagnosed as ventilator-associated pneumonia.The general situation,basic disease,time of mechanical ventilation and the use of corticosteroids were compared between Acinetobacter baumannii group(group ABVAP) and non acinetobacter baumannii group(group NABVAP),using single factor and multiple factor statistical methods to analyze the risk factors of Acinetobacter baumannii ventilator-associated pneumonia.Results Among patients who were selected,29 patients belonged to group ABVAP and 69 patients belonged to group NABVAP.Respiratory diseases(χ2=4.57,P=0.03),the use of corticosteroid ≥7 days(χ2=8.64,P=0.00) were associated with Acinetobacter baumannii ventilator-associated pneumonia.In the multivariate regression,the use of corticosteroid ≥7 days(χ2=5.70,P=0.02) was independent risk factor of Acinetobacter baumannii ventilator-associated pneumonia.Conclusion Comprehensive measures which included shorten the time of using corticosteroid should be adopted to prevent ventilator-associated pneumonia of acinetobacter baumannii.