重症监护室呼吸机相关性肺炎的目标监测与干预

目的了解某医院综合重症监护室（ICU）呼吸机相关性肺炎（VAP）发病情况，以及实施干预措施后的效果。方法对2010年1月-2012年6月入住该ICU使用呼吸机辅助呼吸＞48 h的患者进行目标监测，及时发现问题并采取针对性干预措施，比较干预前后VAP发病率及感染控制措施的依从性。结果共调查1 724例接受呼吸机辅助呼吸患者，其中378 例发生VAP，VAP发病率为21.93%；2010年与2012年（1-6月）VAP发病率分别为51.54‰和19.53‰，两者比较，差异有统计学意义（χ2=12.13，P＜0.01）。2010年、2011年、2012年（1-6月）速干手消毒剂和皂液合计每患者每住院日消耗量分别为5.21 mL/HD、10.98 mL/HD、30.48 mL/HD。结论该院ICU内VAP发病率较高，通过干预措施的有效实施，VAP的发生得到有效控制，医务人员感染控制措施依从性得到提高。

Targeted surveillance and intervention in ventilator associated pneumonia in an intensive care unit

Objective To investigate the occurrence of ventilator-associated pneumonia（VAP） in an intensive care unit （ICU）, and evaluate the efficacy of intervention measures. Methods Patients receiving mechanical ventilation for ~48 h in an ICU from January 2010 to June 2012 were performed targeted surveillance, problems were found out and intervened, incidence of VAP and compliance with infection control measures before and after intervention were compared. Results A total of 1 724 patients with mechanical ventilation were investigated, 21.93%（378 ca- ses） of whom developed VAP; incidence of VAP in 2010 and January-June 2012 was 51.54%o and 19. 53% respec- tively（za = 12. 13,P〈0. 01）. The amount of consumption of hand sanitizer and liquid soap per patient per day in 2010, 2011 and January-June 2012 was 5. 21mL/HD, 10. 98mL/HD and 30. 48 mL/HD respectively. Conclusion The incidence of VAP in this ICU is high, VAP can be controlled effectively through the enforcement of intervention measures and health care workers compliance with infection control measures.