重症监护病房发生呼吸机相关肺炎的病原菌分析及护理

目的了解重症监护病房（intensive care unit,ICU）呼吸机相关肺炎（VAP）发生率、病原菌分布情况和预防措施。方法回顾分析我院2007年10月～2009年9月使用呼吸机的115例患者中出现45例VAP患者的临床资料、病原菌分布以及药敏结果。结果 115例机械通气患者中有45例发生了VAP,VAP发生率为39.1%,病死率为33.3%。共分离出病原菌206株,革兰氏阴性杆菌154株占74.8%,革兰氏阳性菌54株占21.4%,真菌8株占8.9%。结论重症监护病房VAP病原菌以革兰阴性杆菌为主,并有多重耐药;严密动态监测病原菌及耐药性以达到有效控制VAP的目的。针对病原菌的分布及来源,切断病原菌进人肺部的感染途径,缩短有创机械通气时间以达到有效控制呼吸机相关肺炎的发生。

Pathogenic Distribution and Clinical Analysis of Ventilator Associated Pneumonia in Intensive Care Unit

【Objective】To understand the formation rate of ventilator associated pneumonia in intensive care unit,pathogenetic distribution and prevent measure.【Methods】We retrospectively analyzed clinical material,pathogenetic distribution and antibiotic susceptibility data of 45 cases used ventilator from Oct,2007 to Sep,2009.【Results】45 patiens developed VAP among 115 used mechanical ventilation.its development rate is 39.1%.The mortality rate is 33.3%.We altogether separates 206 kinds of pathogenic germ.G-bacillus is 154.it accounts for 74.8%.G ＋ bacteria is 54.It accounts for 21.4%.Fungus is 8,It accounts for 8.9%.【Conclusions】G-bacillus is main pathogetic germ of ventilator associated pneumonia in ICU.CLinical doctors may choice antibiotics reasonably according to drug susceptibility test.