呼吸机相关性肺炎影响因素的logistic回归分析及预防

Influencing Factors and Prevention of Ventilator Associated Pneumonia

目的:了解机械通气患者发生早发及迟发呼吸机相关性肺炎的发生率及影响因素。方法:采用自行编制的调查表,对2011年6月至2013年6月住院的295例机械通气患者进行研究,共有92例发生呼吸机相关性肺炎(纳入病例组),将其他未发生呼吸机相关性肺炎的203例患者作为对照组,对机械通气患者发生呼吸机相关性肺炎的影响因素进行Logistic回归分析。结果:早发与迟发呼吸机相关性肺炎发生率有统计学意义(P<0.05);年龄、上机时间、通气方式、吸痰、气道湿化、卧床体位、血糖和白蛋白水平为机械通气患者发生呼吸机相关性肺炎的影响因素。结论:尽可能缩短机械通气时间,加强基础护理,重视呼吸道的管理,预防和减少机械通气患者呼吸机相关性肺炎的发生。

Objective：To study the incidence and influential factors of early onset and late onset ventilator associated pneumonia in patients using mechanical ventilation. Methods：The clinical data of 295 patients who were hospitalized from June 2012 to June 2013 treated with mechanical ventilation were investigated by using a self - designed questionnaire. Among them,92 cases suffering from ventilator associated pneumonia were assigned into the research group, and the rest in- to the control group. The possible influencing factors of ventilator associated pneumonia in the patients were analyzed by logistic regression analysis. Results： Statistical differences were found in the diagnosis index results of early and late ventilator-associated pneumonia （P 〈 0.05 for both）. By logistic regression analysis, we found that age, breathing time, venti- lation mode, serum albumin, airway humidification, bed rest position, blood glucose and serum albumin levels. Conclusion：The following measures were adopted to reduce the incidence of ventilator-associated pneumonia, including shortening the time, strengthening basic care, paying attention to the management of respiratory tract.