新生儿呼吸机管路细菌学监测分析  

Bacteriological Monitoring of Ventilator Pipe Used for the Newborn

作　　者：邓庆萍[1] 谭南[1] 叶永青[1] 

机构地区：[1]中山市博爱医院,广东中山528403

出　　处：《中华医院感染学杂志》2004年第8期875-877,共3页Chinese Journal of Nosocomiology

基　　金：广东省中山市科研基金课题 (题号 2 0 0 2 A0 6 7)

摘　　要：目的　研究新生儿呼吸机相关性肺炎 (VAP)特点与危险因素及预防措施。方法　对 2 0 0 1年 3月～ 2 0 0 3年 3月收治入我院NICU 10 6例新生儿 ,从上呼吸机治疗第 1～ 7天行呼吸机管路及附属部件和病儿气管深部分泌物的细菌培养 ,同时随机将患儿分成 2组 (研究组 5 6例 ,对照组 5 0例 ) ,采用 2种不同消毒呼吸机管路及附件方法 ,比较不同消毒方法优劣。结果　呼吸机管路细菌阳性率随通气天数增加而增加 ,上机≤ 3d细菌监测结果均为阴性 ,>3d、≤ 7d细菌培养有 6 4例阳性 ;采用过氧乙酸浸泡消毒管路及附件细菌培养监测有 8例阳性 ,需重新消毒灭菌 ,采用环氧乙烷或甲醛熏蒸灭菌细菌监测均为阴性。结论　呼吸机管路及附件更换消毒时间应在 1～ 3d内为宜 ;呼吸机管路及附件消毒应采用初步浸泡消毒 ,严格清洗后干燥经环氧乙烷或甲醛熏蒸灭菌 ,才能确保无菌 ,防止VAP的发生。OBJECTIVE To investigate the characteristics and risk factors of the ventilator-associated pneumonia of the newborn. METHODS A total of 106 newborn babies undergone mechanical ventilation therapy during 2001-2003 in our hospital. The secretion in the pipes and accesories was cultured from the first day to the seventh day. The patients were randomly divided into 2 groups (56 for study group, 50 for control group). Two disinfection methods were compared. RESULTS The bacteria increased by days. Eight examples were positive when immersed in hyperoxide acetic acid. All were negative when fumigated with epoxy ethane or formaldehyde. CONCLUSIONS ①The disinfection time of the ventilator pipe and accesories is better within 3 days. ②In order to prevent VAP, we can immerse them in the disinfectant first, then fumigate with epoxy ethane or formaldehyde after washing and drying .

关 键 词：新生儿 呼吸机相关性肺炎 高危因素 机械通气 NICU 

分 类 号：R722.13[医药卫生—儿科]