机械通气前抗生素应用对呼吸机相关肺炎发病的影响

Effect of Antibiotics before Ventilation on Ventilator Associated Pneumonia

目的:研究机械通气前应用抗生素对呼吸机相关肺炎(VAP)发病的影响。方法:收集我院1997～2000年ICU收治的80例呼衰患者,有26例发生VAP,研究了机械通气前接受过抗生素和未接受过抗生素治疗患者的VAP发生情况。结果:接受组VAP发生率(47.2％)高于未接受组(20.5％),P<0.05,两组有显著差异,晚发性VAP发生率接受组(33.3％)高于未接受组(13.6％),P<0.05,两组有显著差异,早发性的VAP发生率分别为13.9％、6.8％,P>0.05,两组无显著差异,接受组病死率(52.9％)高于未接受组(33.3％),但P>0.05,两组无显著差异。结论:机械通气前应用抗生素(尤其广谱抗生素),能增加VAP发生的危险,合理、科学应用抗生素能减少耐药菌感染,降低VAP发生率。

Objective: To study the influence of antibiotic application before ventilation on ventilated associated pneumonia. Methods: We collected 80 patients of respiratory failure admitted to intensive care unit in 1997-2000 and studied morbidity of ventilated associated pneumonia (VAP) in the patients accepted and unaccepted antibiotic treatment before ventilation. Results: Morbidity of VAP in patients accepted antibiotics (47.2%) was higher than that in the patients unaccepted antibiotic (20.5%), P<0.05. Morbidity of late ventilated associated pneumonia (33.3%) in patients accepted antibiotics was higher than that in the patients unaccepted antibiotic (13.6), P<0.05. Morbidity of early ventilated associated pneumonia was 13. 9 % , 6.8%, respectively, P >0.05. Mortality of VAP in the patients accepted antibiotic ( 52.9 % ) was higher than that in the patients unaccepted antibiotic (33.3%),but P>0.05. Conclusion: Antibiotic application before ventilation can increase morbidity of ventilated associated pneumonia.