ICU呼吸机相关性肺炎危险因素分析

目的:探讨ICU呼吸机相关性肺炎危险因素。方法:选择本院于2013年1¹2月重症监护室收治的300例患者作为研究对象,均应用呼吸机通气支持,统计呼吸机肺炎发生率,并分析患者年龄、性别、体质量指数、白蛋白水平、胃内容物反流、呼吸机应用时间等因素与呼吸机肺炎之间联系,进行统计学分析。结果:300例患者中,应用呼吸机通气支持后,呼吸机相关性肺炎55例(18.3%);经分析,300例患者中,年龄≥60岁126例患者中呼吸机相关性肺炎发生率为47例(37.3%),明显高于<60岁患者8例(4.6%),P<0.05;白蛋白≥30.0g/L、APACHE II评分≥15、应用抗酸剂、胃内容物返流、呼吸机时间≥7d、体质量指数≥25kg/m2、应用糖皮质激素呼吸机肺炎发生率分别为11.5%、29.7%、24.6%、24.3%、26.4%、26.3%、26.0%,均P<0.05;年龄、白蛋白、APACHE II评分、抗酸剂、胃内容物返流、呼吸机时间、体质量指数、糖皮质激素OR值分别为3.34、3.26、2.80、2.31、2.89、4.13、3.23、2.98。结论:ICU呼吸机相关性肺炎发生与患者年龄、白蛋白、APACHE II评分、呼吸机时间等因素相关,临床应加以重视。

Analysis of risk factors of ventilator-associated pneumonia in ICU

Objective：To explore the risk factors of ventilator-associated pneumonia in ICU.Methods：Select 300 cases patients treated in intensive care unit of our hospital in 2013 January-2013 year in December as the research objects,all patients took the ventilator support,then to account the incidence of ventilator-associated pneumonia and analyze relationship between patient age,gender,body mass index,serum albumin,reflux of gastric contents,ventilator time and ventilator-associated pneumonia.Results：After application of ventilator support there were 55 patients with ventilator-associated pneumonia（18.3%）in 300patients;the incidence of ventilator-associated pneumonia was 47cases（37.3%）in 126 patients with aged≥ 60 years and was significantly higher than that 8patients（4.6%）of 〈60 years old,P〈0.05;albumin≥30.0g/L,APACHE II score≥ 15,the application of antacid,regurgitation of stomach contents,ventilator time≥7d,body mass index≥25Kg/m2 and glucocorticoid＇ventilator-associated pneumonia incidence rates were 11.5%,29.7%,24.6%,24.3%,26.4%,26.3%,26%,P〈0.05;patients＇ age,albumin,II score,APACHE antacids,regurgitation of stomach contents,ventilator time,body mass index,glucocorticoid＇OR values were 3.34,3.26,2.80,2.31,2.89,4.13,3.23,2.98.Conclusion：ventilator-associated pneumonia in ICU is associated with patient age,albumin,APACHE II score,ventilator time factors,so clinical should pay more attention.