呼吸机相关性肺炎45例临床分析

Clinical Analysis of 45 Cases of Ventilator Associated Pneumonia in Patients with Mechanical Ventilation

目的 :了解呼吸机相关性肺炎 (VAP)的临床特点及病原菌感染情况。方法 :回顾性总结分析 45例行机械通气患者发生VAP的临床资料。结果 :所有患者均存在一种以上VAP的危险因素 ,多数患者的临床呼吸道感染症状严重。痰培养分离出 61株病原菌 ,其中革兰阴性杆菌占 5 7.4% ,革兰阳性球菌占 19.7% ,真菌占 2 2 .9% ,耐药情况较严重。结论 :内源性和外源性感染皆为VAP发生的原因。临床上应及时诊断 ,积极治疗 ,并应根据细菌药敏检测结果选用抗生素。

Objective:To investigate the clinical features and pathogens of ventilator associated pneumonia(VAP)in patients with mechanical ventilation.Methods:The data of 45 patients were retrospectively analyzed.Results:All of patients have more than one risk factor for VAP and most patients presented moderate or severe clinical picture of respiratory infection.61 strains of bacteria were isolated from specimens.Among them Gram-negative bacilli accounted for 57.4%,Gram-positive cocci 19.7% and fungi 22.9%.Some bacteria showed strong drug resistance.Conclustions:Incidence of VAP in patients with mechanical ventitation is high.Both endogenous and exogenous infection were the major reasons of incidence of VAP.Early diagnosis should be made.Antibiotic choices should be dependent on the result of sputum culture and drug susceptibility test.