新生儿呼吸机相关性肺炎的护理对策

Analysis of the pathogens of ventilator-associated pneumonia in neonates and the nursing strategy

目的探讨新生儿呼吸机相关性肺炎（VAP）的护理对策，以降低VAP的发生率。方法对172例机械通气治疗的新生儿临床资料进行回顾性分析。全部病例均从下呼吸道抽吸出分泌物和气管插管尖端进行细菌培养，机械通气后定期拍摄胸片。结果172例中有37例新生儿发生VAP，发病率21．5％。G^-菌25株（67．6％），G^＋菌12株（32．4％），革兰氏阴性杆菌是VAP的主要致病菌。结论VAP的危险因素甚多，提高预防意识，采取综合防治措施，是控制呼吸机相关性肺炎的最佳策略。

Objective To reduce the occurrence of ventilator-associated pneumonia （VAP） by exploring the preventive nursing strategy. Methods A retrospective analysis over 172 cases of the mechanical ventilation was conducted in NICU. The sputum, collected from the patient＇s airway and the top of tracheal tube was cultured and analyzed in terms of drug-induced allergy. The chest x-ray was made periodically after the mechanical ventilation. Results The 37 cases of 172 cases occurred VAP and the morbidity rate was 21.5%. It was found that G^- bacteria and G^＋ bacteria were 25,15 strain respectively. G^- bacteria was the main pathogens. Conclusion VAP abounds with a lot of risky factors, lt is the optimal strategy to control VAP by improving the awareness of prevention and by compound therapy.