ICU机械通气患者发生呼吸机相关性肺炎的影响因素及其与预后的相关性

Influencing Factors of Ventilator-associated Pneumonia in ICU Patients with Mechanical Ventilation and Its Correlation with Prognosis

目的:探讨重症医学科(ICU)机械通气患者发生呼吸机相关性肺炎(VAP)的影响因素及其与预后的相关性。方法:选择2017年3月-2020年7月重症医学科机械通气患者130例为研究对象,所有患者入院后均完善有关检查,根据是否发生VAP分为发生组(n=30)与未发生组(n=100)。查阅两组资料,并完成单因素及多因素Logistic分析,以及分析ICU机械通气患者VAP发生率与预后的相关性。结果:130例重症医学科机械通气患者30例发生VAP。单因素与多因素结果表明:撤机失败、年龄≥60岁、机械通气时间≥5 d、血清白蛋白<30 g/L、使用抗生素、APACHEⅡ评分≥15分、意识障碍是ICU机械通气患者发生VAP的影响因素(P<0.05)。Pearson分析结果表明:ICU机械通气患者VAP发生率与患者预后呈正相关性(r=0.783,P=0.000);存活组机械通气时间、入住ICU时间及APACHEⅡ评分优于死亡组(P<0.05)。结论:ICU机械通气患者VAP具有较高的发病率,与预后存在相关性,应根据可能的危险因素采取干预措施,改善患者预后。

Objective:To explore the influencing factors of ventilator-associated pneumonia(VAP)in intensive care unit(ICU)patients with mechanical ventilation and its correlation with prognosis.Method:A total of 130 patients with mechanical ventilation in ICU of our hospital from March 2017 to July 2020 were selected as the study subjects,all patients underwent complete examinations after admission.According to whether VAP occurred,they were divided into the occurrence group(n=30)and the non occurrence group(n=100).The data of the two groups were consulted,and the univariate and multivariate Logistic analysis were completed,and analyzed the correlation between the incidence of VAP and prognosis in patients with mechanical ventilation in ICU.Result:VAP occurred in 30 cases of 130 patients with mechanical ventilation.Univariate and multivariate results showed that withdrawal failure,age≥60 years old,mechanical ventilation time≥5 d,serum albumin<30 g/L,antibiotic administration,APACHEⅡscore≥15 points,disturbance of consciousness were risk factors for the occurrence of VAP in mechanical ventilation patients in ICU(P<0.05).Pearson analysis showed that the incidence of VAP was positively correlated with the prognosis of patients with mechanical ventilation(r=0.783,P=0.000);the mechanical ventilation time,ICU stay time and APACHEⅡscore of the survival group were better than those of the death group(P<0.05).Conclusion:The incidence of VAP in patients with mechanical ventilation in ICU is high,and it is correlated with prognosis.Intervention measures should be taken according to the possible risk factors to improve the prognosis of patients.