机械通气前抗生素应用对呼吸机相关肺炎发病的影响

目的；研究机械通气前应用抗生素对呼吸机相关肺炎（VAP）发病的影响。方法：收集我院1997－2000年ICU收治的80例呼衰患者，有26例发生VAP，研究了机械通气前接受过抗生素和未接受过抗生素治疗患者的VAP发生情况。结果：接受组VAP发生充（47．2％）高于未接受组（20．5％），P＜0．05，两组有显著差异，晚发性VAP发生率接受组（33．3％）高于未接受组913．6％），P＜0．05,两组有显著差异，早发性的VAP发生率分别为13．9％、6．8％，P＞0．05，两组无显著差异，接受组病死率（52．9％）高于未接受组（33．3％），但P＞0．05，两组无显著差异。结论：机械通气前应用抗生素（尤其广播抗生素），能增加VAP发生的危险、合理、科学应用抗生素能减少耐药菌感染，降低VAP发生率。

Effect of Antibiotics before Ventilation on Ventilator Associated Pneumonia

Objective: To study the influence of antibiotic application before ventilation on ventilated associated pneumonia. Methods: We collected 80 patients of respiratory failure admitted to intensive care unit in 1997-2000 and studied morbidity of ventilated associated pneumonia (VAP) in the patients accepted and unaccepted antibiotic treatment before ventilation. Results: Morbidity of VAP in patients accepted antibiotics (47.2%) was higher than that in the patients unaccepted antibiotic (20.5%), P<0.05. Morbidity of late ventilated associated pneumonia (33.3%) in patients accepted antibiotics was higher than that in the patients unaccepted antibiotic (13.6), P<0.05. Morbidity of early ventilated associated pneumonia was 13. 9 % , 6.8%, respectively, P >0.05. Mortality of VAP in the patients accepted antibiotic ( 52.9 % ) was higher than that in the patients unaccepted antibiotic (33.3%),but P>0.05. Conclusion: Antibiotic application before ventilation can increase morbidity of ventilated associated pneumonia.