2012~2015年ICU呼吸机相关性肺炎感染目标性监测分析

目的：通过分析2012~2015年重症监护病房(intensive care unit，ICU)呼吸机相关性肺炎(ventilator associated pneumonia，VAP)目标性监测结果，为减少呼吸机相关性肺炎发生提供依据。方法：对2012年1月至2015年12月入住ICU的15474例患者进行医院感染目标性监测，统计医院感染例次及其感染部位，重点观察ICU患者不同年份呼吸机使用情况及VAP发生率，并分析VAP发生危险因素。结果：15474例ICU患者中发生医院感染849例，感染961例次数，感染率、感染例次率分别为5.48%、6.21%，其中VAP感染503例次，占52.34%；2012~2015年呼吸机使用率、VAP感染率呈逐年下降趋势，与采取集束化VA P预防措施有关；VA P相关危险因素中VA P感染组使用制酸剂及激素、昏迷、合并糖尿病比例，APACHE Ⅱ评分、年龄、呼吸机使用时间均明显大于非VAP组，差异有统计学意义(P<0.05)。结论：通过目标性监测了解VAP危险因素等情况，采取针对性的干预措施，我院2012~2015年ICU患者VAP感染率呈现逐年下降趋势。

Objective monitoring and analysis of ventilator associated pneumonia in ICU during 2012~2015

Objective: To analyze the results of objective monitoring of ventilator associated pneumonia (VAP) in intensive care unit (ICU) during 2012~2015 and to provide evidence for reducing the incidence of VAP.Methods:Objective monitoring of hospital infection was performed in 15 474 patients admitted in ICU between January 2012 and December 2015. hTe number of infected cases and infection sites were statistically analyzed. hTe use of ventilator of different years and incidence of VAP in patients in ICU were especially observed. hTe risk factors of VAP were analyzed.Results:Among 15 474 patients in ICU, there were 849 cases with hospital infection and 961 case infected times. hTe infection rate and rate of case infected times were 5.48% and 6.21%, respectively. Among them, 503 case infected times was VAP infection, accounting for 52.34%; in 2012~2015, the usage rate of ventilator and VAP infection rate showed an decreasing trend year by year, which may be related to the implementation of cluster based VAP prevention measures. hTe proportions of cases using antacid and hormone, with coma and complicated with diabetes, APACHEⅡ score, age, duration of ventilator in VAP infection group were larger than non-VAP group (P<0.05).Conclusion: hTrough the objective monitoring to know risk factors of VAP and taking targeted interventions, patients with VAP in ICU of our hospital showed a downward trend year by year from 2012 to 2015.