呼吸机相关肺炎30例研究

Study of 30 cases of ventilator associated pneumonia

目的 了解呼吸机相关肺炎 (VAP)病例的临床病原学特点、影响预后的因素等。方法 采用回顾性资料分析方法。结果 混合感染在死亡组显著高于存活的患者 ,药敏试验显示革兰阴性菌对第三代先锋霉素耐药情况增加 ,对亚胺培南敏感性最佳 ;且很多革兰阴性杆菌对多种抗生素产生耐药性 ,VAP的预后受多种因素影响。结论 使用呼吸机 1周内是VAP易感期 ,应作为预防的重点期 ,预防应从防止外源性致病菌进入和减少内源性致病菌定植两方面着手 ,对VAP的治疗特别要强调降阶梯治疗。

Objective To study the characteristics and prognosis influencing factors of the case of ventilator associated pneumonia (VAP). Methods Retrospective analysis was used .Results Mixed infection in death group is significantly higher than survival group Drug allergic test revealed that the drug endurance effect of 'Loath orchid negative bacteria' to the 3th generation of Cephalosporins increased, while was most sensitive to lmipenem Lots of leath orchid negative bacteria became endurable(resistant) to various antibiotics. The prognosis of VAP was influenced by various pastors. Conclusion With one week after using ventilator is the most vulnerable period for VAP infection ionic should de feasted as the key period for prevention conducted in terms of preventing of outside source pathogenic bacteria and reducing the planting inside source pathogenic bacteria. De-Escalation therapy for VAP should be specially emphasized.