新生儿呼吸机相关性肺炎可控因素分析

The Controllable Factors of Ventilator Associated Pneumonia in Neonates

目的:探讨新生儿呼吸机相关性肺炎(NVAP)发生的可控危险因素,为临床防治提供理论依据。方法:采取病例对照研究设计,以2013年2月-2016年3月中山市博爱医院NICU诊断的42例新生儿呼吸机相关性肺炎为研究组,选择同期呼吸机治疗时间≥48 h的病例,根据胎龄1∶1配对形成对照组,对两组患者的临床资料进行回顾性分析。结果:经多因素Logsitic回归结果显示,使用肺表面活性物质是NVAP发生的保护因素(P<0.001);多次插管和机械通气时长增加是NVAP发生的危险因素(P<0.05)。抗生素使用强度与NVAP发生无明显相关,但对病原学培养结果有重要影响。结论:针对新生儿产生呼吸机相关性肺炎原因,采取积极有效的防治措施,能有效降低呼吸机相关性肺炎发生率。

Objective：To explore the controllable factors of ventilator associated pneumonia in neonates,as to provide theoretical basis for clinical prevention and treatment.Method：It is a case-control study design,42 neonatals who were diagnosed ventilator associated pneumonia in the department of NICU in Boai Hospital of Zhongshan from February 2013 to March 2016 were selected as study group,the cases for the same period whose breathing machine treatment time≥48 h were selected as the control group,according to gestational age 1∶1 matching,the clinical data of two groups were retrospectively analyzed.Result：Multivariate logistic regression showed that using pulmonary surfactant was protective factor of neonatal ventilator associated pneumonia（NVAP）（P〈0.001）;repeated intubation and increased mechanical ventilation time were risk factors of NVAP（P〈0.05）.The intensity of antibiotic was not significantly related to NVAP,but it had important influence on the result of pathogen culture.Conclusion：Causes of ventilator-associated pneumonia in neonates,take effective preventive measures,can effectively reduce the incidence of ventilator-associated pneumonia.