呼吸机相关肺炎发病率及相关危险因素的目标性监测研究

Objective Monitoring Method on Incidence and Risk Factors of Ventilator-Associated Pneumonia

目的探讨呼吸机相关肺炎(VAP)的发病特点及相关危险因素,为制定其预防措施提供科学依据。方法采用目标性监测方法调查ICU病房应用呼吸机患者VAP的发病率,并研究患者口咽部、胃液中、呼吸机的湿化器、冷凝器、螺纹管的微生物定植情况及其它5项危险因素与VAP之间的关系。结果VAP的发病率为61.02%,每千日机械通气感染率为100‰,病死率33.33%;机械通气时间≥7d、患者口咽部微生物定植、APACHEⅡ评分≥15分、呼吸机通气管路微生物定植是VAP的重要危险因素。结论VAP的发病率高,是多种危险因素共同作用的结果。

Objective To approach the feature of morbidity and the risk factors of ventilator-aassociated pneumonia（VAP） and provide objective evidence for the making of preventive measure. Methods With objective monitoring method, the inddence rate of VAP and related risk factors, such as the colonization of microorganism in oropharynx, gastric juice, humidification container, aircooled condenser and corrugated tube of ventilator were investigated. Results The incidence rate of VAP was61.02%, and the incidence rate of every 1000 mechanical ventilator days was 100%. The ease- fatality rate was 33.33%. The lasting time of mechanical ventilator greater than or equal to 7 days, the score of APACHE Ⅱ greater than or e qual to 15, microorganism colonization in oropharynx of or the tube of ventilator were the risk factors of initiating VAP independently. Conclusions There were muhiple factors for the high incidence rate of VAP.