摘要
目的 探讨在内科ICU影响呼吸机相关肺炎（VAP）的危险因素。方法 对2003年8月．2006年8月入住内科重症监护病房（ICU）采用机械通气治疗的220例患者进行回顾性分析，将患者按相关危险因素自然分组，采用，检验比较VAP发病率。结果220例行机械通气治疗患者中有147例发生VAP，发病率为66．8％。机械通气≥5d、仰卧位、应用抑制胃酸分泌药、进行侵入性操作、应用糖皮质激素、白蛋白〈30g／L、多器官功能障碍综合征（MODS）与各自对照组比较，其相对比分别是2．73、1．82、2．45、5．67、2．76、3．49、2．06倍，P值均〈0．05，有统计学意义。结论 机械通气≥5d、仰卧位、应用抑制胃酸分泌药、进行侵入性操作、应用糖皮质激素、白蛋白〈30g／L、多器官功能障碍综合征（MODS）是影响VAP发生的主要危险因素。
Objective To study the risk factor for ventilator - associated pneumonia（VAP）. Methods A retrospective cohort study was donducted in 220 patients who had received mechanical ventilation in intensive care unit from August 2003 to August 2006. Chi - square test was adopted to ananlyze the VAP incidence rate and related risk factors, respectively. Results The diagnosis of VAP was established in 147 cases with the incidence rate of 66.8%. The duration of mechanical ventilation 〉 5 day, supine posture, gastric acid secretion inhibitor therapy, invasive operation, corticosteroid use, albumen 〈 30g/L, and multiple organ dysfunction syndrome（MODS） were the risk factors for VAP, with odds ratios 2. 73, 1.82, 2.45, 5.67, 2.76, 3.49 and 2.06, respectively（all P〈0.05）. Conclusion The duration of mechanical ventilation 〉5 day, supine posture, gastricacid secretion inhibitor therapy, invasive operation, corticosteroid use, albumen 〈 30g/L, and MODS were the risk factors for VAP.
