“5T”方案综合防治新生儿呼吸机相关肺炎的临床探讨

Clinical exploration of "5T" comprehensive project in the prevention and treatment of neonatal ventilator-associated pneumonia

目的 探讨“5 T”综合治疗方案对呼吸机相关肺炎(ventilator associated pneumonia,VAP)的防治作用。方法 回顾分析我院NICU病房2 0 0 0年8月～2 0 0 4年8月间应用呼吸机治疗时间超过4 8h的332例病例,将应用“5 T”方案的192例作为A组,未用该方案治疗的14 0例作为B组,比较两组的VAP发病率、死亡率、VAP的发生时间、上机时间。结果 A组患儿比B组患儿VAP发病率、死亡率明显降低(P<0 .0 5 )、A组患儿比B组患儿VAP的发生时间延长、上机时间缩短,差异有非常显著性(P<0 .0 1)。结论 “5 T”综合治疗方案对新生儿呼吸机相关肺炎有较好的防治作用。

Objective To explore t he application of '5T' comprehensive pro ject in the prevention and treatment of ventilator-associated pneumonia(VAP) in neonatal intensive care unit(NICU) patie nts.Methods A retrospective case-c ontrol study was conducted on 332 cases who needed ventilator for more than 48 h ours in our NICU during August 2000～Augu st 2004.Group A,192 cases,was treated by '5T' project,while Group B,149 cases,wa s not treated by '5T' project.The incide nce,mortality rate,the time of the occur ring of VAP and the time of using ventil ator were compared between the two group s.Results The incidence and mortal ity of VAP in group B was significantly higher than in group A(P<0.05).The tim e of the occurring of VAP in group A was significantly prolonged.The time of usi ng ventilator in group B was significan tly longer than in group A(P< 0.01 ). Conclusion '5T' comprehensive proje ct has a good effect on VAP.