新生儿呼吸机相关性肺炎的研究进展

Progress in neonatal ventilator-associated pneumonia

新生儿呼吸机相关性肺炎（ventilator-associated pneumonia，VAP）的诊断标准目前还不够完善；其危险因素包括体位、医务人员配置情况、有创操作等；母乳喂养、加强医务人员教育管理、提高护理水平可降低VAP发病率；抗酸药物、选择性消化道净化、皮肤保护剂是否能降低VAP发病率还有争议；新生儿VAP的病原菌国内主要是肺炎克雷伯杆菌、大肠杆菌、铜绿假单胞菌、鲍曼不动杆菌杆等；VAP应采用综合的防治措施，合理选用抗生素，并注意全身支持治疗。

At present, the standard for the diagnosis of ventilator-associated pneumonia（ VAP） is imperfect. The risk factors of VAP include body position, medical staffing, invasive procedure and so on. To strengthen the education and management of medical staff, improve the standard of care and breast feeding can reduce the incidence rate of VAP. There are controversial that H2 blockers/sucralfate, selective digestive tract decontamination and topical treatment with skin barrier can reduce the incidence rate of VAP. Common pathogenic bacteria of VAP are Klebsiella pneumoniae, Escherichia coli, Pseudomenas aeruginosa, Baumanii and so on in our country. Compreh-ensive prevention and treatment measures including selection of antibiotics appropriately and generalized supportive therapy should be applied.