新生儿重症监护病房呼吸机相关性肺炎感染的目标性监测与控制

Target Monitoring and Control of Ventilator-Associated Pneumonia in Neonatal Intensive Care Unit

目的探讨新生儿重症监护病房呼吸机相关性肺炎(VAP)的发病率,有针对性地采取控制措施。方法采用目标性监测方法,对本院2008年1月—2010年12月新生儿重症监护病房VAP感染发病情况进行监测,并对VAP危险因素进行分析,提出具体的预防控制措施。结果监测期间共发生VAP 22例次,呼吸机使用天数1 202 d,VAP日感染率为18.30‰。2008年、2009年和2010年VAP日感染率比较,差异有统计学意义(χ2=6.51,P<0.05)。不同胎龄、出生体质量、机械通气时间患儿VAP感染率比较,差异均有统计学意义(P<0.05)。22例VAP患儿的呼吸道分泌物中共培养出病原菌9株,共检测到6例耐药菌。结论根据新生儿重症监护病房VAP感染发生的特点,开展目标性监测可以有效地降低VAP感染的发生。

Objective To investigate the incidence of ventilator-associated pneumonia（VAP） in neonatal intensive care unit（NICU） and to propose targeted prevention and control measures.Methods Target monitoring was applied to investigate the incidence of VAP in NICU from January 2008 to December 2010,with the risk factors analyzed in order to propose specific prevention and control measures.Results Twenty-two cases of VAP were noted during the monitor period.Total number of ventilation days were 1 202.Daily VAP infection rate was 18.30‰,with statistical differences among the years of 2008,2009,and 2010（χ2=6.51,P0.05）.VAP incidence rates among infants with different gestation,born weight,and ventilation time were significantly different（P0.05）.A total of 9 strains of pathogenic bacteria were isolated from respiratory secretions of the 22 cases,with 6 strains were with drug resistance.Conclusion According to the characters of VAP in NICU,targeted monitoring can reduce the infection rate of VAP effectively.