重症监护病房患者呼吸机相关性肺炎发生原因分析及对策

目的探讨重症监护病房患者发生呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)的危险因素,以便提出针对性护理对策。方法对198例使用机械通气患者进行前瞻性病例检测,分析感染的危险因素。结果重症监护病房发生VAP的主要病原菌中革兰氏阴性杆菌占58.8%,革兰氏阳性杆菌占29.8%,真菌占11.4%;VAP患者感染发生率随机械通气时间延长而有增加的趋势。结论机械通气、病房环境、患者及医务人员因素、侵入性操作、应用抗酸剂、滥用抗生素等为重症监护病房患者发生VAP的主要危险因素。针对患者发生VAP的原因,采取针对性的预防性护理措施,可有效切断VAP感染途径和减少感染率。

Objective To investigate the risk factors of ventilator-associated pneumonia （VAP） infection in ICU and summarize nursing strategies. Method Prospective tests were taken on 198 patients using mechanical ventilation, and the risk factors of infection were analyzed. Results Of the main pathogens of ventilator-associated pneumonia in ICU, gram-negative bacillus, gram-positive bacteria and fungi accounted for 58.8%, 29.8%, and 11.4%, respectively. The major risk factors of ventilator-associated pneumonia infection in ICU included mechanical ventilation, ward environment, patients and medical personnel, incursion operation, the application of antacid and the abuse of antibiotics. Conclusion Preventive nursing is of particular importance to cut off the route of VAP infection and reduce the infection rate.