肝移植术后患者呼吸机相关性肺炎的影响因素及护理

目的探讨肝移植术后呼吸机相关性肺炎(ventilator associated pneumonia,VAP)的临床及病原学特点。方法对2003年9月至2006年8月实施肝移植术后进行机械通气治疗的136例患者调查分析。结果52例患者出现VAP,发生率为38.23%,病死率为34.61%;88.46%的VAP发生在术后4d之后;病原菌以革兰阴性菌为主,占84.38%。结论肝移植术后患者应用机械通气治疗过程中,针对VAP发生的危险因素,采取积极有效的防治措施,对控制感染、降低病死率有着非常重要的意义。

Ventilator Associated Pneumonia after Liver Transplantation:the Influencing Factors and Nursing Care

Objective To investigate the clinical and pathogenic characteristics of ventilator associat- ed pneumonia(VAP)after liver transplantation.Methods A total of 136 patients who were put on mechanical ventilator after liver transplantation from September 2003 to August 2006 were investi- gated.Results Fifty-two patients developed ventilator associated pneumonia.The morbidity of ventilator associated pneumonia was 38.23% and the mortality was 34.61%.We also found that 88.46% of VAP occurred within 4 days after transplantation,with Gram-negative bacteria being the predominant(84.38%).Conclusion During mechanical ventilation after liver transplantation, effective measures should be taken to control the risk factors of VAP,reducing infection and lower- ing the mortality.