胃液细菌定植与重症脑出血患者呼吸机相关肺炎的关系研究

The relationship between intragastric bacteria colonization and the incidence of VAP in patients with serious cerebral hemorrhage

目的:研究重症脑出血机械通气患者胃内细菌定植在呼吸机相关性肺炎(VAP)发病中的作用。方法:对2011-01-2013-01入住我院急诊重症监护病房的重症脑出血机械通气患者进行胃液、口咽及下呼吸道标本的细菌培养,分析这3类标本的细菌种类是否存在一致性,同时检测胃液的pH值。结果:重症脑出血机械通气患者胃液、口咽及下呼吸道的标本细菌种类存在一致性,且定值组胃液pH值显著高于非定值组(P<0.01)。结论:与胃液pH值升高相关的胃内细菌定植是重症脑出血机械通气患者VAP病原菌的重要来源。

Objective：To investigate the role of intragastric bacteria colonization in the pathogenesis of ventilator associated pneumonia（VAP）in serious cerebral hemorrhage undergoing mechanical ventilation.Method：Bacteriological examination was made for the samples of gastric fluid,lower respiratory tract and pharyngeal swab of sixty-two serious cerebral hemorrhage undergoing mechanical ventilation patients admitted to our Emergency Intensive Care Unit（EICU）from January 2011 to January 2013.The consistency of the three kinds of samples was analyzed.At the same time,the pH value of gastric fluid was measured.Result：There was homogeneity among the samples of gastric fluid,lower respiratory tract and pharyngeal swab of serious cerebral hemorrhage undergoing mechanical ventilation patients（P〈0.01）.The pH value in the patients with intragastric bacteria colonization was higher than in the patients without it（P〈0.01）.Conclusion：Intragastric bacteria colonization which is associated with pH value increased of gastric fluid is one of the infection sources of VAP in serious cerebral hemorrhage undergoing mechanical ventilation patients.