新生儿呼吸机相关性肺炎的临床分析

Clinic Analysis of Neonatal Ventilator-Associated Pneumonia

目的:分析新生儿呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)的高危因素、病原菌,探讨临床降低VAP发生率的策略。方法:回顾分析2004年3月—2009年12月97例行机械通气的新生儿临床资料,其中并发VAP42例,比较胎龄,出生体质量,上机时间,以及分析病原学检测结果。结果:VAP发生率43.3%;VAP组上机时间明显多于非VAP组:不同胎龄、出生体质量的VAP的发生率有显著差异,致病病原菌以肺炎克雷伯菌、阴沟肠杆菌、大肠埃希菌、铜绿假单胞菌多见。结论:VAP是多因素综合作用的结果,必须重视并预防VAP,采取综合措施减少VAP的发生。

Objective：The high-risk factors and the pathogens of neonatal ventilator-associated pneumonia（VAP） were analyzed to inquire into the tactics of how to reduce the incidence of the disease.Methods： Retrospective study was conducted in 97 infants given mechanical ventilation from Mar.2004 to Dec.2009.Among the 97 infants,42 with VAP were compared 55 without VAP in terms of the gestational age,the born weight,the duration using mechanical ventilation and the bacteria culture results.Results： The overall incidence of VAP was 43.3%.Infants with VAP had a longer ventilation time.The difference of gestational age and born weight between 42 VAP and 55 without VAP was statistically significant;Klebsiella pneumoniae,E.coli and Pseudomonas aeruginosa were the main pathogenice bacteria.Conclusions： VAP is caused by more than one factor.Synthetical tactics can reduce the incidence of the VAP.