重症医学科呼吸机相关性肺炎的发生及其危险因素分析

Risk factors of ventilator-associated pneumonia in intensive care unit

目的探讨重症医学科呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)的发生及其危险因素,以便更好地指导临床工作。方法采用查阅病例的方式,回顾性分析158例在重症医学科住院行机械通气患者的临床资料,分析患者VAP的发生及其危险因素。结果机械通气时间、留置胃管是重症医学科患者VAP发生的主要危险因素(P<0.01)。结论每天评估患者停止机械通气的可能性,尽早停止机械通气;保持口咽清洁,减少细菌定植;加强环境清洁和空气消毒管理;做好气管切开的护理;提高护理操作技术水平对降低VAP的发生具有重要的作用。

Objective To analysis the occurrence and risk factors of ventilator-associated pneumonia（VAP）in intensive care unit in order to direct the clinical work.Method The clinical data of 158 cases receiving mechanical ventilation in ICU were retrospectively analyzed to investigate the incidence of VAP and risk factors.Result Mechanical ventilation and intubation of nasogastric tubes were the main risk factors of VAP（P〈0.01）.Conclusion The nursing measures such as earlier extubating,keeping the oropharynx clean,decreasing the risk of colonization,strengthening disinfection and air purification,paying attention to the tracheotomy nursing and enhancing nursing procedure skills are important for VAP prevention.