呼吸机相关性肺炎危险因素的研究

目的 探讨引起呼吸机相关性肺炎的相关因素及预防对策.方法 2008年1月-2010年12月医院采用机械通气治疗患者160例,以呼吸机相关性肺炎患者作为观察组,无呼吸机相关性肺炎者作为对照组,比较两组可能相关因素上的差异,进行单因素检验及logistic回归分析.结果 160例患者中发生呼吸机相关性肺炎50例,发生率为31.25％；单因素检验12个变量是影响呼吸机相关性肺炎的危险因素(P＜0.05) ;logistic回归分析显示独立危险因素为:APACHEⅡ评分高(OR=4.56)、机械通气时间长(OR=3.23)、头部仰卧位置(OR=3.02)、年龄大(OR=2.98)、应用抗酸剂(OR=2.23).结论 呼吸机相关性肺炎发生率较高,应针对上述因素实施相应的对策以减少呼吸机相关性肺炎的发生.

Risk factors for ventilator-associated pneumonia

OBJECTIVE To explore the risk factors for ventilator-associated pneumonia and the preventive countermeasures.METHODS From Jan.2008 to Dec.2010,a total of 160 patients who underwent the treatment with mechanical ventilation were enrolled in our hospital.The patients with ventilator-associated pneumonia were set as the study group,and the patients without ventilator-associated pneumonia were set as the control group.The differences in the possible related factors between the two groups were compared.Univariate analysis and logistic regression analysis were performed.RESULTS Ventilator-associated pneumonia occurred in 50 of the 160 patients with the incidence of 31.25%.Univariate analysis demonstrated that 12 variables were the risk factors for ventilator-associated pneumonia(P<0.05);logistic regression analysis showed that the independent risk factors were as the following:high APACHE Ⅱ score(OR=4.56),long time of mechanical ventilation(OR=3.23),head supine position(OR=3.02),old age(OR=2.98),and the application of acid agents(OR=2.23).CONCLUSION The incidence of ventilator-associated pneumonia is high.Corresponding measures should be implemented according to factors mentioned above to reduce ventilator correlation pneumonia.