呼吸机相关性肺炎目标监测与控制

Targeted monitoring and control of ventilator associate pneumonia

目的探讨新生儿重症监护病房(NICU)呼吸机相关性肺炎发生情况及其感染危险因素,为临床预防控制提供依据。方法采用目标性监测方法对2011年1月-2013年12月NICU机械通气时间≥2d的患儿816例进行监测,分析其呼吸机相关性肺炎发生情况及其感染危险因素,采用SPSS17.0进行统计分析。结果共有198例患儿发生呼吸机相关性肺炎,发生率为24.3%;气管插管、胎龄<37周和机械通气时间>7d是SICU呼吸机相关性肺炎的独立危险因素(P<0.05)。结论 NICU呼吸机相关性肺炎与多个因素有关,临床应重点观察独立危险因素,积极开展感染监测,并采取有效的预防控制措施,降低呼吸机相关性肺炎发生率。

OBJECTIVE To investigate the situation and risk factors of ventilator associated pneumonia in neonatal intensive care unit,so as to provide the basis for clinical prevention and control.METHODS By objectively monitoring,totally 816 patients with more than 24 hours mechanical ventilation treatment in our hospital neonatal intensive care unit from Jan.2011 to Dec.2013 were monitored.The occurrence and risk factors of ventilator associated pneumonia were analyzed,and all data were analyzed by SPSS 17.0software.RESULTS A total of 198 cases of patients appeared ventilator associated pneumonia,and the incidence rate was 24.3%.The trachea cannula,gestational age less than 37 weeks and mechanical ventilation time more than 7days were belonging to independent risk factors for ventilator associated pneumonia in neonatal intensive care unit（P〈0.05）.CONCLUSION Multiple factors are related to ventilator associated pneumonia in neonatal intensive care unit.The independent risk factors should be intensively observed in clinical treatments.And the infection monitoring and preventive measures should be put into effect to reduce the incidence of ventilator associated pneumonia.