新生儿呼吸机相关性肺炎危险因素分析

Risk factors for ventilator-associated pneumonia in neonates

目的探讨新生儿呼吸机相关性肺炎(VAP)的危险因素,提出有针对性的护理措施,从而降低新生儿病死率、改善预后。方法回顾性分析573例行维持机械通气的新生儿临床资料,统计VAP的发生率,对相关危险因素进行单因素χ2检验和多因素logistic回归分析。结果共有204例发生VAP,发生率为35.60%;胎龄(<37周)、体位(平卧位)、机械通气时间(≥5.63d)、出生体质量(<2 500g)和胃内容物吸入是VAP发生的独立危险因素(P<0.05)。结论新生儿VAP与早产、低出生体质量、平卧位、胃内容物吸入和机械通气时间过长等有关,应根据上述危险因素采取针对性的护理措施,来降低VAP的发生率,改善预后。

OBJECTIVE To explore the risk factors for ventilator-associated pneumonia （VAP） in the neonates and put forward targeted nursing interventions so as to reduce the mortality of the neonates and improve prognosis. METHODS The clinical data of 573 neonates who underwent maintained mechanical ventilation were retrospectively analyzed, then the incidence of VAP was taken for statistics, and the univariate chi-square test and multivariate logistic regression analysis were performed for the related risk factors. RESULTS The VAP occurred in 204 patients, with the incidence of 35.60%. The gestational age less than 37 weeks, horizontal body position, mechanical ventilation duration no less than 5.63 days, birth weight less than 2 500g, and aspiration of gastric contents were the independent risk factors for VAP （P〈0.05）. CONCLUSION The VAP in the neonates is associated with the premature delivery, low birth weight, horizontal body position, aspiration of gastric contents, or mechanical ventilation duration. It is necessary to take targeted nursing measures according to the risk factors so as to reduce the inci- dence of VAP and improve the prognosis.