ICU呼吸机相关性肺炎的危险因素及预防对策研究

Study on the Risk Factors and Prevention Countermeasures of ICU Ventilator Associated Pneumonia

目的探讨ICU呼吸机相关性肺炎(VAP)的危险因素及其预防对策,为今后的临床预防工作提供可靠的参考依据。方法随机选择2014年1月至2015年12月入住我院ICU接受呼吸机机械通气治疗期间出现VAP患者30例为观察组,同时选取30例未出现VAP患者为对照组。观察分析临床引起VAP的危险因素,并制定相应的预防措施。结果观察组患者误吸以及应用抗菌药物、糖皮质激素和抗酸剂的比例均高于对照组患者,差异具有统计学意义(P<0.05)。观察组患者的平均年龄、呼吸机使用时间均显著大于对照组患者,白蛋白水平显著低于对照组患者,差异具有统计学意义(P<0.05)。结论 VAP与患者高年龄、误吸、白蛋白水平低、呼吸机使用时间过长、临床应用药物不当等因素密切相关,应针对可变危险因素采取预防控制措施,以减少临床感染率。

Objective To explore the risk factors and preventive measures of ICU ventilator associated pneumonia （VAP）, in order to provide reliable reference for future clinical prevention works. Methods 30 ICU patients treated with mechanical ventilation and presented VAP in our hospital from January 2014 to December 2015 were set as observation group, 30 ICU patients who didn＇t present VAP were set as control group. The risk factors of VAP in clinic were observed and analyzed, the corresponding prevention measures were formulated. Results The rates of aspiration and application of antibacterial agents, glucocorticoids and antacids in observation group were significantly higher than those in control group, with statistical difference （P 〈0.05）. The average age and application time of ventilator in observation group were significantly larger than those in control group, and the albumin level was significantly lower than that in control group, all the difference was statistical （P 〈0.05）. Conclusions VAP is closely related with patients＇s high age, aspiration, low albumin level, long application time of ventilator and misuse of drugs. Prevention and control measures should be conducted according to variable risk factors, in order to reduce the clinical infection.