新生儿呼吸机相关性肺炎感染因素分析

Risk factors of ventilator-associated pneumonia in neonates

目的分析新生儿呼吸机相关性肺炎的感染危险因素,为新生儿呼吸机相关性肺炎的防治提供理论依据。方法调查分析新生儿重症监护病房2008年6月-2012年6月收治的193例使用呼吸机行机械通气时间>48h患儿临床资料。结果共有94例发生呼吸机相关性肺炎,发生率为48.7%;发生呼吸机相关性肺炎患儿中,男性与女性比较,差异无统计学意义;研究组:孕期(29.5±6.3)周、出生体重(2778±617)g、机械通气时间(123.3±21.4)h、插管次数(3.1±1.9)次、吸痰次数(19.4±7.1)次、平卧率50.0%、静脉置管率41.5%;对照组:孕期(34.7±6.8)周、出生体重(3046±609)g、机械通气时间(93.6±17.8)h、插管次数(1.8±0.9)次、吸痰次数(10.8±8.2)次、平卧率24.2%、静脉置管率42.4%。结论新生儿发生呼吸机相关性肺炎与患儿自身状态和临床治疗干预等多种因素相关,针对患儿产生呼吸机相关性肺炎原因,采取积极有效的防治和护理措施,能有效降低呼吸机相关性肺炎发生率。

OBJECTIVE To analyze the risk factors of neonatal ventilator-associated pneumonia（VAP）so as to offer the basic theory of prophylaxis and treatment.METHODS A total of 193cases of neonates who received the mechanical ventilation more than 48hours in neonatal intensive care unit from June 2008to June 2012 were enrolled in the study,then the clinical data of the neonates were analyzed.RESULTS Totally 94patients developed VAP,and the infection rate was 48.7%.The difference in the incidence of VAP between the male neonates and the female neonates was not significant.In the study group,the pregnant period was（29.5±6.3）weeks,birth weight（2778±617）g,duration of mechanical ventilation（123.3±21.4）h,frequency of intubation（3.1±1.9） times,frequency of sputum suction（19.4±7.1）times,horizontal position rate 50.0%,and rate of intravenous intubation 41.5%;in the control group,the pregnant period was（34.7±6.8）weeks,birth weight（3046±609） g,duration of mechanical ventilation（93.6±17.8）h,frequency of intubation（1.8±0.9）times,frequency of sputum suction（10.8±8.2）times,horizontal position rate 24.2%,and rate of intravenous intubation 42.4%.CONCLUSIONThe incidence of VAP in the neonates is related to such factors as their own state and the clinical interventions.It is necessary to take effective prevention and nursing measures based on the risk factors of the VAP so as to reduce the incidence of VAP.