ICU内呼吸机相关性肺炎发生危险因素分析

RISK FACTORS OF VENTILATOR-ASSOCIATED PNEUMONIA IN ICU

目的探讨重症监护病房（ICU）内呼吸机相关性肺炎（VAP）发生危险因素。方法选取ICU内机械通气超过48h的病人72例，根据VAP发生情况分为VAP组31例和非VAP组41例，分析VAP发生独立危险因素。结果VAP发生率为43．06％。单因素分析显示，急性生理评分（APACHE）Ⅱ评分、肺部原发病、机械通气时间、口腔护理（口护）方式、声门下吸引是vAP发病的相关因素（χ2=5．513～16．371，P〈0．05）。多因素Logistic回归分析显示，APACHEⅡ评分、肺部原发病、机械通气时间、口护方式及声门下吸引均是VAP发病的独立危险因素（OR=1．548～16．371，P〈0.05）。结论ICU内VAP的发生与多种因素相关，应采取针对性措施降低VAP发生。

Objective To explore risk factors of ventilator-associated pneumonia （VAP） in intensive care units （ICU）. Methods Seventy-two patients with more than 48 hours of mechanical ventilation in ICU of our hospital were selected, and divided into VAP group （n=31） and non-VAP group （n= 41） according to whether VAP was occurred. The independent risk factors of VAP were analyzed. Results The incidence of VAP was 43.06%. Univariate analysis showed that acute physiology （APACHE） Ⅱ score, pulmonary primary disease, duration of mechanical ventilation, mouth care and suction under glottis were relevant fac tors attributing to VAP （χ2=5.513--16.371 ,P〈0.05）. Multivariate logistic regression analysis indicated that APACHE Ⅱ score, pulmonary primary disease, duration of mechanical ventilation, mouth care, and suction under glottis were all independent patho genic risk factors of VAP （OR=1.548--16.371,P〈0.05）. Conclusion The occurrence of ventilator-associated pneumonia in ICU is related to a variety of factors, measures should be taken to reduce the incidence of this condition.