新生儿呼吸机相关性肺炎影响因素临床分析

目的该研究旨在初步探讨新生儿呼吸机相关性肺炎(VAP)的发病率和影响因素,为VAP的防治提供理论依据。方法回顾分析2008～2010年郴州市第一人民医院NICU治疗的256例机械通气危重新生儿的临床资料。结果 VAP发病率为39.84%。单因素分析显示早产儿、低体重、机械通气时间、吸痰次数、再气管插管、头部位置、有无大剂量使用丙种球蛋白等因素与VAP有关(P<0.05)。Logistic回归分析显示早产儿、机械通气时间、吸痰次数、再气管插管为VAP影响因素(P<0.05),头部位置、有无大剂量使用丙种球蛋白为VAP发生的保护因素。结论 VAP影响因素众多,是患者本身疾病状态与外部医疗环境多因素作用的结果,采取综合防治措施是减少VAP发生的最佳策略。

Objective This study was designed to investigate the incidence and the effect factors of neonatal VAP to offer the basic theory of prophylaxis and treatment about VAP.Methods The clinical data of 256 critical neonates who were treated with mechanical ventilator in the first People＇s hospital of Chenzhou between 2008 and 2010 was studied retrospectively.Results 102 out of the 256 patients developed VAP（39.84% ） ,Univariate analysis showed that preterm infant,low birth weights,duration of mechanical ventilation,frequence of suction,reintubation,position of head and gamma globulin administration were associated with the development of VAP（P0.05）.Multivariate stepwise logistic regression analysis showed that preterm infant ,duration of mechanical ventilation,frequence of suction,reintubation were associated with the development of VAP（P0.05）,and position of head and high dose gamma globulin administrationwere protected factors for the development of VAP.Conclusion The effect factors of VAP is multifactorial,including patients’internal status of disease and external medical environments.It’s an optimum tactics to take comprehensively protective measures to release the incidence of VAP.