NICU早产儿医院获得性肺炎相关危险因素的研究

Risk factors for hospital-acquired pneumonia of premature children in NICU

目的探讨新生儿重症监护病房(NICU)早产儿医院获得性肺炎的危险因素,为临床降低早产儿发生医院获得性肺炎提供理论依据,并制定预防控制措施。方法研究医院2010年1月-2011年4月NICU发生与未发生医院获得性肺炎的患儿,分为病例组和对照组,对影响因素进行logistic多因素回归分析。结果住NICU天数,病例组(26.08±2.42)d,对照组为(9.52±0.66)d;危重评分,病例组(90.60±0.75)分,对照组为(96.72±0.62)分;羊水性状(OR=15.385,P=0.020)、新生儿危重评分(OR=1.315,P=0.001)、气管插管(OR=26.399,P=0.022)、胃管喂养(OR=9.174,P=0.045)、住院NICU天数(OR=1.179,P=0.039)是早产儿患医院获得性肺炎的危险因素。结论早产儿患医院获得性新生儿肺炎有其自身器官发育不完全的因素,也存在外部潜在的危险因素,应该加强对早产儿患医院获得性肺炎危险因素的防护,并加强医院感染的监测,降低早产儿医院获得性肺炎的发生率。

OBJECTIVE To investigate the risk factors of nosocomial acquired pneumonia in premature children so as to reduce nosocomial infections and provide a reference for pneumonia prevention and control.METHODS Preterm children with and without nosocomial pneumonia in NICU ward of our hospital from Jan.1,2010 to Apr.30,2011 were enrolled into the case group and control group.Risk factors were analyzed by logistic regression.RESULTS Length of NICU stay,amniotic fluid properties,neonatal critical score,endotracheal intubation,feeding tube were the risk factors for hospital-acquired pneumonia in premature children.CONCLUSION Premature newborn child suffering from hospital-acquired pneumonia has its own incomplete organ development problems and there were also external potential risk factors.We must control the controllable risk factors,such as strict aseptic medical routine,hand hygiene and environmental disinfection.