某医院呼吸机相关肺炎危险因素研究

The analysis of related risk factors for ventilator associated pneumonia in a hospital

目的研究呼吸机相关肺炎(VAP)相关危险因素,为有效控制其感染率提供依据。方法通过呼吸机相关肺炎患者临床资料分析,以某医院重症监护病房29例VAP患者为对象进行VAP感染因素研究。结果本次调查的29例VAP患者接受机械通气时间均超过48 h,在179例机械通气患者中,VAP发生率为16.2%。患者年龄、机械通气时间,格拉斯评分<9在VAP患者死亡因素中具有统计学意义。从VAP患者送检标本中检出革兰阴性菌占感染菌总数的84.2%,多重耐药菌中鲍曼不动杆菌的检出率高达60%。结果该医院接受机械通气的患者VAP发生率较高,高龄患者、机械通气时间和抗菌药物的大量应用存在相关性。

Objective To study the risk factors causing ventilator associated pneumonia（ VAP） for controlling the incidence of VAP accordingly. Methods Analysis of clinical data of 29 patients who developed VAP in ICU of a hospital was used to study the infection related factors. Results There were 179 patients in total who had received mechanical ventilation for more than 48 hours. Among them 29 cases developed VAP,with the incidence of 16. 2%. The age,the duration of mechanical ventilation and that GCS 9 were all statistically significant in the factors related to the death of VAP patients.Gram- negative bacteria was found to be the main pathogenic bacteria for VAP and accounted for 84. 2%. Among the multi- resistant bacteria,Acinetobacter baumannii accounted for 60%. Results The incidence of VAP in this hospital is high,which is associated with the elderly patients,the duration of mechanical ventilation and the extensive use of antimicrobial drug.