呼吸机相关性肺炎护理相关因素分析及对策

目的探讨ICU病房中使用呼吸机机械通气患者发生呼吸机相关性肺炎（VAP）的护理相关危险因素及护理对策，为临床防治VAP提供科学依据。方法回顾性分析2005年12月至2006年12月使用呼吸机〉48h的90例患者临床资料，选择与机械通气肺部感染相关的因素进行分析。结果VAP的发生率为58．9％（53／90），病死率为26．4％（14／53）。患者的年龄、是否吸烟、营养状况、带机体位、与呼吸机进行机械通气的连接方式、带机时间、频繁吸痰、雾化吸入、经鼻胃管、胸背部物理治疗和误吸等与VAP的发生相关，与性别及口腔护理有关。结论加强ICU全方位管理，严格无菌技术和消毒隔离，改善患者营养，患者尽量采用半卧位，正确的翻身拍背，缩短带机时间，减少不必要的吸痰、雾化吸人和误吸等危险因素，是降低VAP发生的有效措施。

Nursing strategies of Ventilator-Associated pneumonia

Objective To discuss Nursing strategies of Ventilator-Aasociated pneumonia in Intensive Care Unit. Methods The clinical data of 90 patients with mechanical ventilate surpassed 48 hours were retrospectively studied in Intensive Care Unit between Dcember 2005 and December 2006. Results The age, smoking, nutrition, body posture, linked pattern with ventilator, mechanical ventilate time, aspirate aputum, mists inhaled, gastric pipe,chest-back treatment and regurgitation and aspiration of these patients were related closely to VAP (P<0.05).Conclusion It is an effective way to prevent VAP by eliminating or decreasimg these related risk factors for Ventilator-Associated Pneumonia.