重症监护病房呼吸机相关性肺炎感染高危因素的探讨

目的探讨重症监护病房(ICU)呼吸机相关性肺炎(VAP)发生的高危因素。方法回顾性分析93例入科时无肺部感染且机械通气时间>48h的患者,应用自行设计的表格记录每例研究对象的相关资料,采用单因素分析VAP的危险因素及与死亡的关系。结果 93例患者中,VAP组42例,发生率为45.2%,死亡27例,死亡率为64.3%;未发生VAP组死亡18例,死亡率为35.3%;单因素分析结果显示,昏迷、糖皮质激素使用、制酸剂使用和鼻胃管留置均为VAP发生的危险因素;是或否使用预防性抗菌药物在VAP发生率上差异无统计学意义;APACHEⅡ评分与死亡率有显著相关性。结论对机械通气尤其存在高危因素的患者,应严密监测,加强护理,规范侵入性操作,尽量缩短机械通气时间,避免VAP的发生。

High-risk factors of ventilator-associated pneumonia in intensive care unit

OBJECTIVE To determine the factors in patients with ventilation of developing pneumonias in intensive care unit.METHODS Data was gathered from a total of 93 patients with mechanical ventilation for more than 48 hours and without pneumonia when admitted,than analyzed the high-risk factors related to VAP and whether VAP increased mortality with Chi-square test.RESULTS There were 23 of 93 patients developed pneumonia,the incidence rate of VAP were 45.2%,and the mortality rate of VAP and non-VAP were 64.3% and ...