COPD呼吸机相关性肺炎82例临床分析

Analysis of 82 Patients with Ventilator-Associated-Pneumonia in Medical ICU

目的:分析我院慢性阻塞性肺疾病(COPD)在ICU行机械通气治疗患者呼吸机相关性肺炎(VAP)的流行病学特点、危险因素、病原菌构成及耐药情况,对临床诊断和治疗提供参考。方法:对2010年1月至2012年12月我院收治的ICU慢性阻塞性肺病发生VAP感染的患者82例进行分析。结果:同期收治ICU慢性阻塞性肺病患者333例,其中发生VAP感染的患者82例,感染率为24.62%。主要致病菌为革兰阴性杆菌,其中以鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯杆菌为主;革兰阳性菌以金黄色葡萄球菌为主;真菌感染以白色念珠菌和曲霉菌为主。结论:我院慢性阻塞性肺疾病患者ICU呼吸机相关性肺炎感染率较高,以革兰阴性杆菌为主,耐药率普遍较高,应根据病原学合理使用抗生素,预防VAP的发生。

Objective： To study the epidemiological characteristics,risk factors, the aetiological characteristics and bacterial susceptibility in patients with ventilator- associated- pneumonia. Methods： To review the 82 patients with ventilator- associated- pneumonia and cancer in medical ICU from January 2010 to December 2012. Results： 24. 62% of patients suffered from the VAP. The main pathogenic bacterium were Gram- Negative bacillus,including Acinetobacter baumannii,Pseudomonas aeruginosa and klebsiella pneumoniae. Gram- positive coccus were chiefly Straphloclccus aureus and fungi were Blastomces alblicans and Aspergillus. Conclusion： Infection rates of ventilator- associated pneumonia in ICU of the hospital are high. The dominant bacterium in patients with VAP was GNB,and all bacteria showed high ressitance to common antibiotics. Clinical tactics emphasis select suitable antibiotics on the basis of aetiological analysis and integrated control. Preventing risk factors of nosocomial infection should be taken as appropriate control measures.