早产儿40例呼吸机相关性肺炎危险因素探讨及预防对策

The Exploration of the Risk Factors and Prevention of Ventilator-associated Pneumonia in 40 Premature Infants

目的分析并评价早产儿呼吸机相关性肺炎的危险因素及预防对策。方法选择佛山南海第六人民医院2010年5月至2012年11月收治的70例行机械通气的早产儿作为研究对象,其中40例为呼吸机相关性肺炎组;其余30例为非呼吸机相关性肺炎组。比较两组早产儿在胎龄、出生体质量、留置胃管时间、通气持续时间、气管插管次数、性别以及窒息史等方面的差异。结果两组早产儿在胎龄、出生体质量、插管次数、留置胃管时间、通气持续时间、气管插管次数等方面比较,有统计学意义(χ2=15.68,9.81,9.18,7.97,14.68,P<0.05);两组患儿性别及窒息史比较,无统计学意义(χ2=0.72,0.09,P>0.05)。结论胎龄小、出生体质量低、气管插管次数多、留置胃管与机械通气时间长等因素可显著增大早产儿呼吸机相关性肺炎的发生率。

Objective To analyze and evaluate the risk factors of ventilator-associated pneumonia and preventive measures in premature infants. Methods Seventy premature infants with mechanical ventilation from Foshan Nanhai Sixth People＇s Hospital during May 2010 and Nov. 2012 were selected,40 cases with ventilator-associated pneumonia as the observation group and the other 30 cases as control group. The gesta- tional age, birth weight, gastric tube reserving time, duration of ventilation, the number of endotracheal intuba- tion times, gender and asphyxia of the two groups were compared. Results There were significant differences in gestational age, birth weight, gastric tube reserving time, duration of ventilation, the number of endotracheal intubatian times between the two groups （ χ^2 = 15.68,9.81,9.18,7.97,14.68, P 〈 0.05 ） , and there were no differences in gender and history of asphyxia （ χ^2 = 0. 72 ,0. 09 ,P 〈 0.05 ） between the two groups. Con- clusion Small gestational age,low birth weight, frequent tracheal intubation times, long gastric tube reser- ving and mechanical ventilation time are factors which can significantly increase the incidence of ventilator- associated pneumonia in the premature infants.