呼吸机相关性肺炎危险因素探讨

【目的】探讨影响呼吸机相关肺炎（VAP）的危险因素。【方法】对入住呼吸科重症监护病房（RICU）采用机械通气治疗的86例患者进行回顾性队列研究，将患者按相关危险因素自然分组，比较VAP发病率，并进行多因素非条件Logistic回归分析。【结果】86例行机械通气治疗的患者中VAP发病率为48．8％（42／86）。原发病主要以肺部疾患为主、机械通气≥5d、仰卧位、应用抑制胃酸分泌药、进行侵入性操作、应用糖皮质激素、白蛋白〈30g／L，是影响VAP发生的危险因素。【结论】机械通气原发病主要以慢性肺部疾患为主、较长时间机械通气、仰卧位、是否应用抑制胃酸分泌药（制酸剂）、侵入性操作、应用糖皮质激素、白蛋白〈30g／L，是影响VAP发生的主要危险因素。

Study on the Risk Factors of Ventilator-associated Pneumonia

[Objective] To investigate the risk factors of ventilator-associated pneumonia （VAP）. [Methods]A retrospective cohort study was conducted in 86 patients who had received mechanical ventilation in intensive care unit. Chi square test and logistic regression were adopted to analyze the VAP incidence rate and related risk factors, respectively. [Results]The incidence rate of VAP was 48.8%. The major primary disease was lung disease. The duration of mechanical ventilation ≥5d, supine position, gastric acid secretion inhibitor（GASI） therapy, invasive operation, corticosteroid use and albumen 〈30g/L were the risk factors for VAP. [Conelusion]The major primary disease of mechanical ventilation is lung disease. The duration of mechanical ventilation ≥5d, supine posture, GASI therapy, invasive operation, corticosteroid use and albumin 〈30g/L are the main risk factors for VAP.