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目的探讨新生儿呼吸机相关性肺炎(VAP)的高危因素和防治方法。方法回顾分析2000～2005年江门市妇幼保健院NICU呼吸机治疗的98例危重新生儿的临床资料。结果VAP发生率为46.94%;VAP与胎龄、出生体重呈负相关,与机械通气(MV)时间、插管次数、MV次数呈正相关(P<0.01);病原菌主要是耐药性条件致病菌,以革兰阴性杆菌为主(80.39%),革兰阳性球菌次之(13.73%);多次上机者还培养出2株真菌;继发VAP与否明显影响治愈率(P<0.05)。结论VAP与胎龄、出生体重、MV时间、插管次数、MV次数密切相关;致病菌主要是耐药性条件致病菌;综合防治至关重要。

High risk factors, prevention and treatment of neonatal ventilator-associated pneumonia

Objective To investigate the high risk factors,prevention and treatments of neonatal ventilator-associated pneumonia.Methods Retrospective study was made on the clinical data of 98 critical neonates who were treated with ventilator in our hospital's NICU in the latest 5 years.Results The incidence of VAP was 46.94%,and the gestational ages and the birth weights were negatively correlated,but the duration of MV,the times of intubation and MV were positively correlated (P<0.01).The main pathogens were opportunistic drug-resistant bacteria,and mostly were G - bacilli (80.39%),then G + cocci ( 13.73%);2 strains of fungi were found in the cases of repeated MV;complicating with VAP or not had a significant effect on the cure rate (P<0.05).Conclusion The incidence of VAP has a close correlation with the gestational ages,the birth weights,the duration of MV,and the times of intubation and MV.The main pathogens are drug-resistant opportunistic bacteria;integrated prevention and treatment are very important.