新生儿获得性肺炎危险因素分析及护理对策

Analysis of Risk Factors of Neonatal Acquired Pneumonia and Nursing Strategies

目的结合临床实践经验,探讨新生儿获得性肺炎危险因素,并实施相应的护理对策。方法选取2015年1月1日-2019年12月31日某院收治的382例新生儿,分析其中191例新生儿获得性肺炎患儿病原菌分布情况,对新生儿临床资料进行单因素分析,并对新生儿发生获得性肺炎影响因素进行多因素Logistic回归分析。结果 191例新生儿获得性肺炎患儿共检出129例致病菌,其中革兰阴性菌株97株(74.62%),以大肠埃希菌最为常见;革兰阳性菌22株(17.03%),以金黄色葡萄球菌最常见;真菌10株(7.69%),均为白色假丝酵母菌。经过χ^2检验,胎龄<37周、出生体重<2500克、剖宫产、非母乳喂养、宫内窘迫、羊水污染、胎膜早破、有侵入性操作为新生儿发生获得性肺炎的影响因素,差异有统计学意义,P<0.05。经过Logistic回归分析,胎龄<37周、出生体重<2500克、剖宫产、非母乳喂养、宫内窘迫、羊水污染、有侵入性操作均为可能导致新生儿发生获得性肺炎的独立危险因素,差异有统计学意义,P<0.05。结论新生儿获得性肺炎与多种因素存在密切关联,其病原菌以大肠埃希菌为主的革兰阴性菌最为常见,应采取适当的护理对策进行干预,降低新生儿发生获得性肺炎风险。

Objective Combined with clinical experience,to explore the risk factors of neonatal acquired pneumonia,and implement the corresponding nursing countermeasures.Methods From January 1,2015 to December 31,2019,382 newborns in our hospital were analyzed retrospectively.The distribution of pathogens in 191 cases of neonatal acquired pneumonia was analyzed,the clinical data of newborns were analyzed by univariate analysis,and the influencing factors of neonatal acquired pneumonia were analyzed by multivariate Logistic regression analysis.Results In 191 cases of neonatal acquired pneumonia,129 pathogenic bacteria were detected,including gram-negative bacteria 97(74.62%),Escherichia coli the most common;Gram-positive bacteria 22(17.03%),Staphylococcus aureus the most common;fungi 10(7.69%),Candida albicans.According toχ^2 test,gestational age<37 weeks,birth weight<2500g,cesarean section,invasive operation,non breast feeding,intrauterine distress,amniotic fluid pollution,premature rupture of membranes were the influencing factors of neonatal acquired pneumonia,the difference was statistically significant(P<0.05).According to logistic regression analysis,gestational age<37 weeks,birth weight<2500g,cesarean section,invasive operation,non breast feeding,intrauterine distress,amniotic fluid pollution,premature rupture of membranes were all independent risk factors that may lead to acquired pneumonia in neonates,the difference was statistically significant(P<0.05).Conclusion Neonatal acquired pneumonia is closely related to many factors.Gram-negative bacteria,mainly Escherichia coli,are the most common pathogens.Appropriate nursing measures should be taken to reduce the risk of neonatal acquired pneumonia.