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吉林地区院内肺炎危险因素的巢式病例对照研究

RISK FACTORS OF NOSOCOMIAL PNEUMONIA IN JILIN:A NESTED CASE-CONTROL STUDY
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摘要 采用巢式病例对照研究的方法 ,探讨院内感染性肺炎 (NP)的致病危险因素。对 2 0多种可能的危险因素进行单因素分析 ,有 17种呈显著性差异。对这 17种主变量进行多因素条件性Logistic回归分析 ,其中意识障碍 (OR =11.0 819)、气管切开 (或插管 ) >2周 (OR =9.6 5 13)、手术持续时间≥ 4h(OR =7.315 4)、预防性应用抗生素 (OR =8.96 98)、免疫功能低下 (OR =6 .886 1)、应用激素 (OR =6 .5 896 )、应激性溃疡预防用药 (OR =12 .6 371)、留置胃管 (OR =9.95 14)、多器官功能衰竭 (OR =10 .2 836 )为NP发生的独立危险因素。本研究证明NP的发生是多因素综合作用的结果 ,且证明存在胃→咽→下呼吸道的逆行感染途径。 To explore the risk factors of nosocomial pneumonia(NP), the nest case control study was taken. By analyzing more than twenty factors, the differences of seventeen factors were of significance. The results of multiple stepwise logisticregression showed that: mental impairment(OR=11.0819), duration of tracheostomy>2 weeks(OR=9.6513),operation duration≥4h (OR=7.3154),combined use of antibiotics(OR=8.9698), lowering of immunity (OR=6.8861),use of cortical hormone(OR=6.5896),prophylactic therapy for stress ulcer (OR=12.6371), retention of nosogastric tube (OR=9.9514) were risk factors.It was suggested that there was a retrograde route of infection from the stomach to throat and then lower respiratory tract, and NP was the result of multiple risk factors.
出处 《解放军医学杂志》 CAS CSCD 北大核心 2001年第5期363-365,共3页 Medical Journal of Chinese People's Liberation Army
基金 全军"九五"青年基金资助课题!(编号 98Q0 3 0 )
关键词 交叉感染 肺炎 危险因素 巢式病例对照研究 LOGISTIC模型 医院内感染 cross infection pneumonia risk factors nested case control studies logistic models
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参考文献4

  • 1[1]Daschner F. Stress ulcer prophylaxis and ventilation pneumonia.Infect Control Hosp Epidemiol, 1996,13 : 59
  • 2[2]Tryba M. Gastric alkalinieation and systemic infection: the controversy. Scand J Gastroenterol Suppl, 1996,211: 53
  • 3[3]Bonten MJ. The role of intragastric acidity and stress ulcer prophylaxis on colonization in mechanically centilated ICU patients. Am J Respir Care Med, 1995,152:1825
  • 4[4]Martone WJ. National infection surveillance semianual report.Am J Infect control, 1996,23(6): 377

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