呼吸机相关性肺炎的好发因素及病原学分析

目的分析急诊内科ICU呼吸机相关性肺炎的好发因素及病原学、药敏情况。方法分析本院急诊内科ICU近4年来收治的48例呼吸机相关性肺炎患者的好发因素、病原学药敏结果。结果呼吸机相关性肺炎的好发因素:年龄、呼吸机使用时间延长、APACHEII评分增高、低蛋白血症、抗生素及激素的使用、肠内营养返流,进行计数统计,P0.05,有统计学差异。呼吸机相关性肺炎主要以革兰氏阴性杆菌(65.4%)为主,其次为革兰氏阳性球菌(21.8%),现在真菌(12.8%)感染日益增多。结论使用呼吸机的患者需注意避免呼吸机相关性肺炎的好发因素,一旦发生呼吸机相关性肺炎,可经验性使用革兰氏阴性杆菌敏感的抗生素,同时及时的病原培养药敏检查。

Etiological analysis and predisposing factors of ventilator associated pneumonia

Objective To explore the risk factors and pathogens of ventilator-associated pneumonia in emer-gency ICU science. Methods The risk factors and drug sensitivity results of patients with ventilator-associated pneu-monia were analyzed. Results The risk factors of ventilator-associated pneumonia included age, the prolonged use of ventilator, increased APACHEII score, hypoproteinemia, antibiotics and hormones, and enteral nutrition reflux （ P〈0. 05）. The main pathogens of ventilator associated pneumonia included gram-negative bacilli （65. 4%）, followed by gram-positive cocci （21. 8%） and fungal infection （12. 8%）, which showed a increasing tendency recently. Con-clusion Patients given ventilator should be paid attention to avoiding the risk factors of ventilator-associated pneumo-nia. Once ventilator-associated pneumonia occurs, they can be treated with anti-gram-negative bacilli antibiotics. At the same time, they should be given pathogen culture and drug sensitive test.