呼吸机相关性气管-支气管感染与肺炎的对照分析  

Comparative analysis of ventilator-associated bronchial infection and ventilator-associated pneumonia

作　　者：阎锡新[1] 王海宾[1] 张鲁涛[1] 张聚静[1] 王保法[1] 

机构地区：[1]河北医科大学第二附院呼吸科,河北石家庄050000

出　　处：《中国抗感染化疗杂志》2005年第5期278-281,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的研究呼吸科重症监护病房(RICU)内两组机械通气患者临床资料和致病菌的细菌学情况,以探讨RICU内下呼吸道医院感染的治疗和预防措施。方法对RICU内的45例机械通气患者,依据临床症状、X线胸片和下呼吸道分泌物的细菌定量培养及药敏结果,分为典型呼吸机相关性肺炎(VAP)组(A组)22例;呼吸机相关性气管-支气管感染(VABI)组(B组)23例。分析两组间临床与病原学差异。结果A组住院时间、机械通气时间、胃管留置时间和病死率明显高于B组。B组感染发生时间早于A组。结论RICU内机械通气患者,特别是COPD患者,呼吸机相关性支气管感染早期发现有利于防止VAP发生,降低病死率。Objective This analysis was to study the difference between ventilator-associated pneumonia （VAP） and ventilatorassociated bronchial infection （VABI） in the patients admitted to respiratory intensive care unit （RICU）, which may be helpful for finding ways to protect patients from VAP. Methods Forty-five cases in RICU were included in this analysis based on clinical manifestation, quantitative microbiological culture results from tracheal secretion collected 48 h, 1 week, and 2 weeks after intubation. These patients were divided into two groups： VABI and VAP. Results It was found that among the 45 cases, 22 were VAP, 23 VABI. The mortality rate of VAP was much higher, with longer RICU stay and longer ventilation time. Conclusions For RICU patients with ventilation, especially those with COPD, VABI has relatively lower mortality when compared to VAP. Early diagnosis and management of VABI is helpful for preventing VAP and reducing mortality.

关 键 词：呼吸科重症监护病房 机械通气 呼吸机相关性肺炎 呼吸机相关性支气管感染 

分 类 号：R563.1[医药卫生—呼吸系统]