新生儿重症监护病房呼吸机相关性肺炎感染目标性监测

Target monitoring of ventilator- associated pneumonia in neonatal intensive care unit

目的：探讨新生儿重症监护病房（NICU）呼吸机相关性肺炎（VAP）的危险因素,并采取针对性措施进行防控。方法：目标性监测2011年1月-2013年12月该院NICU收治的564名危重新生儿VAP的发生率,并对VAP的危险因素及感染病原菌进行考察分析。结果：564名危重新生儿中VAP患儿共211例,VAP发生率为37.4%;共使用呼吸机天数958天,日感染率为22.0%。与目标性监测前（2007-2010年）相比,VAP发生率及日感染率均显著下降,差异均有统计学意义（P〈0.05）。患儿的胎龄、出生体重、机械通气（MV）时间及插管次数均影响VAP的发生率。结论：经目标性监测,掌握VAP的特点,并制定相应的干预计划,可有效降低该病的发生和发展。

Objective： To explore the risk factors of ventilatorassociated pneumonia （VAP） in neonatal intensive care unit （NICU）, take targeting measures to prevent and control VAP. Methods： The incidence rate of VAP in 564 critically ill neonates in NICU was monitored, the risk factors of VAP and infection pathogens were analyzed. Results： Among 564 critically ill neonates, 211 neonates were found with VAP, the incidence rate of VAP was 37.4% ; the neonates used ventilator for 958 days totally, the daily intection rate was 22. 0%. Compared with before monitoring, the incidence rate of VAP and the daily infection rate decreased significantly, there were statistically significant differences （P 〈 0. 05） . The influencing factors of VAP incidence rate included fetal age, birth weight, duration time of mechanical ventilation and times of intubation. Conclusion： Conducting targeting monitoring, grasping characteristics of VAP and taking corresponding intervention measures can effectively reduce the occurrence and development of VAP.