重症监护室呼吸机相关性肺炎患者危险因素及其护理对策

Risk factors of ventilator-related pneumonia in intensive care units and their nursing countermeasures

目的分析重症监护室发生呼吸机相关性肺炎(VAP)的危险因素,并制定相应护理对策。方法选择2021年1—12月于本院重症医学科接受机械通气的80例患者为研究对象,以是否发生VAP分为两组,即VAP组(21例)与非VAP组(59例)。收集分析患者年龄、性别、是否手术、机械通气时间、意识状态等资料,经单因素分析、二元Logistic回归分析、ROC曲线分析对其影响因素进行分析。结果单因素分析显示,机械通气时间、意识状态、是否使用抗生素治疗是VAP发生的影响因素,差异有统计学意义(P<0.05);二元Logistic回归分析显示,机械通气时间>5天、深镇静状态、使用抗生素治疗是VAP发生的主要因素,差异有统计学意义(P<0.05);ROC曲线分析可知,机械通气时间对VAP的预测效能为63.8%,意识状态对VAP的预测效能为77.9%,是否使用抗生素治疗对VAP的预测效能为32.2%。结论重症监护室呼吸机相关性肺炎的防治过程中应该关注患者机械通气时间、意识状态、是否使用抗生素治疗等方面,同时根据相关因素采取针对性护理措施,能有效提高防治水平。

Objective To analyze the risk factors of ventilator-related pneumonia in ICU,and formulate corresponding nursing countermeasures.Methods A total of 80 patients underwent mechanical ventilation in department of critical care medicine of our hospital from January 2021 to December 2021 were enrolled as study subjects.According to the occurrence of ventilator associated pneumonia(VAP),the patients were divided into two groups,namely VAP group(21 cases)and non-VAP group(59 cases).The data such as age,gender,surgery,time of mechanical ventilation,and consciousness status were collected.Univariate analysis,binary Logistic regression analysis,and ROC curve were used to analyse the influencing the factors of VAP.Results The univariate analysis revealed that,time of mechanical ventilation,state of consciousness,the use of antibiotic therapy are the factors influencing the occurrence of VAP,the differences were statistically significant(P<0.05).The binary Logistic multivariate analysis showed that the mechanical ventilation time over 5 days,the deep sedation status,and the antibiotic treatment were the main influencing factors for the occurrence of VAP,the differences were statistically significant(P<0.05).According to the analysis of the ROC curve,the efficiency of mechanical ventilation time on VAP was 63.8%,deep sedation affected 77.9%and antibiotics affecting 32.2%of VAP.Conclusions In the prevention and treatment process of ventilator-related pneumonia in intensive care units,medical staff should pay attention to the mechanical ventilation time,consciousness state,use of antibiotics,etc.At the same time,targeted care according to the relevant factors could effectively improve the prevention and treatment level.