非人工气道患者医院获得性肺炎的危险因素

Risk Factors for Hospital Acquired Pneumonia in Patients Without Artificial Airways

目的:探讨非人工气道患者医院获得性肺炎(HAP)发生的危险因素。方法:收集北京丰台医院2006年10月至2008年9月确诊HAP 117例非人工气道患者作为观察组,与同期未发生HAP的117例非人工气道患者作为对照组,采用单因素和logistic多因素回归分析。结果:单因素分析显示年龄、吸烟、中枢神经系统疾病、慢性阻塞性肺疾病(COPD)/支气管扩张、心力衰竭、糖尿病、意识障碍、被动体位、误吸、制酸剂、抗菌素和外科手术12种因素差异有统计学意义(P<0.05),是HAP患病的可能危险因素。而无创呼吸机通气不增加HAP发生的危险。但是lo-gistic多因素回归分析确定年龄、COPD/支气管扩张和外科手术是非人工气道患者HAP发生的独立危险因素。结论:年龄、COPD/支气管扩张和外科手术是非人工气道患者HAP发生的危险因素。

Objective： To investigate the risk factors of hospital acquired pneumonia（HAP） in patients without artificial airways.Methods： One hundred and seventeen cases of HAP without artificial airways in Beijing Fengtai hospital from Oct.2006 to Sep.2008 were reviewed retrospectively,and 117 patients without HAP in the same setting were studied as control,risk factors for HAP were analyzed by t test,chi square test and logistic regression analysis.Results： Advanced age,cigarette smoking,central nervous system disease,chronic obstructive pulmonary disease（COPD） / bronchiectasis,heart failure,diabetes mellitus,consciousness disturbance,as well as passive position,aspiration,administration of histamine（H2） antagonists or antacid and antibiotics,and surgical operations were associated with HAP in patients without artificial airways.And noninvasive ventilation was not associated with HAP.Advanced age,COPD/ bronchiectasis and surgical operations were found as independent risk factors（OR were 3.29,2.30 and 3.05,respectively） for HAP.Conclusion： Advanced age,COPD/ bronchiectasis and surgical operations were independent risk factors for HAP in patients without artificial airways.