预防呼吸机相关性肺炎的护理体会

Nursing Experience in Prevention of Ventilator Associated Pneumonia

目的：探讨呼吸机相关性肺炎的预防及护理经验。方法：回顾性分析我市中心医院重症监护室确诊为呼吸机相关性肺炎（VAP）患者的临床特点、病原菌感染情况及采取的护理措施。结果：病原菌构成比最大的前三种细菌为假单胞菌属、金黄色葡萄球菌和克雷伯菌属，分别占28．9％、21．9％和17．4％。其中各类病原菌混合感染者76例（89％），单一感染者为9例（11％）。机械通气时间〈3d，病原菌检出率为38．6％，3—17d检出率为89．5％，〉7d检出率为100％。结论：严格无菌技术和消毒隔离，加强呼吸机管路系统及呼吸道管理，合理使用抗生素是降低VAP发生的有效措施。

Objective： To discuss the prevention and nursing experience in ventilator associated pneumonia. Methods： To take a retrospective analysis on the clinical features, bacterial infection and adopted nursing measures for the patients with ventilator associated pneumonia ＂（VAP） diagnosed by the intensive care unit of our Central hospital. Results： The first three major bacteria include Pseudomonas, Staphyloccocus anreus Rosenbach and Klebsiella, occupying 28.9%, 21.9% and 17.4% respectively. Where, there were 76 eases with infection of mixed bacteria （89%1 and 9 eases with infection of single bacteria （11%）. When the time of mechanical ventilation 〈 3d, the detection rate was 38.6%, for the time of 3-7d, the rate was 89.5% and for the time 〉 7d, the rate was 100%. Conclusion： The effective measures to reduce the occurrence of VAP include the strict aseptic technique, disinfection and isolation, strengthening of ventilator tube system and respiratory tract management, and reasonable application of antibiotics.