住院危重患者发生呼吸机相关肺炎的影响因素

Influence factors of ventilator-associated pneumonia in critically ill inpatients

目的探讨住院危重患者发生呼吸机相关肺炎(VAP)的影响因素。方法选取2013年10月到2014年12月德阳市人民医院收治的重症监护患者140例进行研究,将患者按照是否发生VAP分为VAP组与非VAP组,分析VAP发病的相关因素。结果根据数据统计,VAP组患者和非VAP组患者的年龄和性别差异均无统计学意义(P>0.05)。VAP组患者和非VAP组患者的住院时间、气管留置时间、血清蛋白、吸痰次数、吸烟史、呼吸系统史和慢性健康状况(APACHEⅡ)评分,差异有统计学意义(P<0.05)。经过VAP发生的多因素分析,与VAP发生的相关因素包括住院时间、气管留置时间、吸痰次数、呼吸系统史和APACHEⅡ评分,经概率型非线性(Logistic)回归分析,差异有统计学意义(P<0.05)。结论住院危重患者发生VAP的影响因素很多,其中,最主要的影响因素包括住院时间、气管留置时间、血清蛋白、吸痰次数、吸烟史、呼吸系统史和APACHEⅡ评分。

Objective To explore the influence factors of ventilator associated pneumonia（VAP） in the criti‐cally ill inpatients .Methods 140 intensive care patients in our hospital from October 2013 to December 2014 were se‐lected to conduct the study and divided into the two groups according to whether VAP occurrence .The VAP onset related factors were analyzed .Results According to the data statistics ,the age and gender had no statistical differ‐ence between the VAP group and the non‐VAP group（P 〉 0 .05） .The length of hospital stay ,tracheal catheter in‐dwelling time ,length of hospital stay ,serum protein ,sputum suction frequency ,smoking history ,history of the respir‐atory system and APACHE Ⅱ scores had statistically significant differences between the VAP group and the non‐VAP group（P〈 0 .05） .By the multiple factors analysis for VAP occurrence ,the VAP occurrence related factors in‐cluded the hospital stay duration ,tracheal catheter indwelling time ,sputum suction frequency ,respiratory system his‐tory and APACHE Ⅱ scores all had statistical significance bythe Logistical regression analysis（P〈 0 .05） .Conclusion The VAP occurred in the critically ill inpatients has many related factors ,in which the main influencing factors in‐clude the length of hospital stay ,tracheal indwelling time ,serum protein ,sputum suction frequency ,smoking history , respiratory system history and APACHE Ⅱ scores .