早产儿呼吸机相关性肺炎高危因素分析

Analysis of risk factors of preterm children at high risk of ventilator-associated pneumonia

目的探讨早产儿呼吸机相关性肺炎(VAP)的高危因素及预防措施。方法回顾性分析60例早产儿的临床特点,将患儿分为VAP及非VAP组,比较两组间胎龄、原发病、贫血、机械通气的时间、再插管及预防性抗生素使用的发生率有无差异。所有病原学分析采用气道分泌物培养。结果早产儿VAP的多因素逐步Logistic回归分析显示,各危险因素在发生VAP中的作用大小顺序依次为:再插管、机械通气时间、气管内吸引、胎龄、原发病、贫血、使用中枢抑制剂;预防性静脉应用丙种球蛋白(IVIG)为预防发生VAP的保护性因素。结论综合性的防治措施能有效地预防和治疗早产儿呼吸机相关性肺炎。

Objective To investigate the（VAP） risk factors and preventive measures of preterm children ventilator-associated pneumonia. Methods A retrospective analysis of 60 cases the clinical features of premature children,patients were divided into non-VAP and VAP group and compared between gestational age,primary disease,anemia,mechanical ventilation time,re-intubation and prophylactic antibiotic use whether the differences in incidence.All etiology of airway secretions using culture. Results The preterm children VAP in multivariate Logistic regression analysis showed that the risk factors in the occurrence of VAP in the order of the size of the role： re-intubation,mechanical ventilation,endotracheal suctioning,gestational age,primary disease,anemia,the use of central inhibitors;Prophylactic intravenous gamma globulin（IVIG） to prevent the occurrence of VAP protective factors. Conclusions Comprehensive prevention and control measures are effective in prevention and treatment of premature children ventilator-associated pneumonia.