新生儿呼吸机相关肺炎预防中手卫生作用的探讨

Evaluation of hand hygiene in the prevention of ventilator-associated pneumonia in neonates

目的探讨手卫生在新生儿呼吸机相关肺炎（VAP）预防中的作用。方法采取回顾性与前瞻性相结合的调查方法，比较2004-2007年间新生儿重症监护室（NICU）改善手卫生设施前后的VAP发生情况。结果在不改变其他条件的情况下，改善洗手及手消毒设施后，VAP发生率显著降低；由之前的30．00％（2004-2005年）降至18．18%（2006-2007年），且两者差异有高度显著性（x^2=9．44，P〈0．01）。结论手卫生是预防VAP的重要环节，设置完善、方便的洗手和手消毒设施，提高医务人员手卫生依从性，是降低VAP发生率的关键措施之一。

Objective To evaluate the effect of hand hygiene in the prevention of ventilator-associated pneumonia （VAP） in neonates. Methods By combination of retrospective and prospective methods, the occurrence of VAP of neonates in neonatal intensive care unit （NICU） was compared before and after the improvement of hand hygiene between 2004-2007. Results When the other conditions were not changed, the incidence of VAP reduced obviously from 30. 00% （2004-2005） to 18. 18%（2006 2007） after improving the hand washing method and facilities, there was significant difference between the two（x^2 = 9. 44, P〈0. 01）. Conclusion Hand hygiene is an important process to prevent VAP, one of the key measures to reduce the occurrence of VAP are perfect hand washing methods and facilities and the compliance of health care workers.