呼吸重症监护病房铜绿假单胞菌肺部感染临床分析

A clinical analysis of Pseudomonas aeruginosa pulmonary infection in respiratory intensive care unit

目的探讨呼吸重症监护病房(Respiratory intensive care unit,RICU)铜绿假单胞菌(Pseudomonas aeruginosa,PA)肺部感染对治疗及预后的影响。方法对2008年1-12月入住我院RICU的PA感染组(21例)和非PA感染组(42例)患者的性别、年龄、吸烟史、基础疾病、病原菌分布、药敏试验结果、住院时间、住院费用、侵袭性操作及预后情况进行回顾性研究。结果 PA感染组对亚胺培南的耐药率高达71.4%。PA感染组气管插管或气管切开、有创机械通气率明显高于非PA感染组(P<0.01)。PA感染组的平均住院日延长,人均住院费用增加,好转率降低(P<0.01)。结论有创机械通气是RICU患者合并PA肺部感染的危险因素。

Objective To investigate the effect of Pseudomonas aeruginosa（PA） pulmonary infection on the treatment and prognosis of patients in respiratory intensive care unit（RICU）.Methods A retrospective case-control study was conducted on 21 patients with PA infections（PA infection group） and 42 patients with non-PA infection（control group）.The patients＇ clinical indices including sex,age,smoking history,underlying disease,pathogenic bacteria distribution,drug sensitive test result,hospitalization time,hospitalization expense,invasive operation and prognosis were analyzed respectively.Results The resistance rate of PA to Imipenem accounted for 71.4% in PA infection group.The incidences of endotracheal intubation,tracheostomy and invasive mechanical ventilation of the PA infection group were obviously higher than those of the control group（P0.01）.As compared with the control group,patients of the PA infection group had longer hospitalization time,higher hospitalization expenses and lower improvement rate（P0.01）.Conclusion Invasive mechanical ventilation is a risk factor for patients complicated with PA pulmonary infection in RICU.