新生儿呼吸机相关性肺炎的高危因素和防治  

High risk factors,prevention and treatment of neonatal ventilator-associated pneumonia

作　　者：邓筹芬[1] 吴玉宇[1] 钟红磊[1] 潘健儿[1] 陈艳娟[1] 江洪清[1] 李定华[1] 

机构地区：[1]江门市妇幼保健院儿科,广东江门529000

出　　处：《中国实用儿科杂志》2006年第4期283-285,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨新生儿呼吸机相关性肺炎(VAP)的高危因素和防治方法。方法回顾分析2000～2005年江门市妇幼保健院NICU呼吸机治疗的98例危重新生儿的临床资料。结果VAP发生率为46.94%;VAP与胎龄、出生体重呈负相关,与机械通气(MV)时间、插管次数、MV次数呈正相关(P<0.01);病原菌主要是耐药性条件致病菌,以革兰阴性杆菌为主(80.39%),革兰阳性球菌次之(13.73%);多次上机者还培养出2株真菌;继发VAP与否明显影响治愈率(P<0.05)。结论VAP与胎龄、出生体重、MV时间、插管次数、MV次数密切相关;致病菌主要是耐药性条件致病菌;综合防治至关重要。Objective To investigate the high risk factors, prevention and treatments of neonatal ventilator-associated pneumonia. Methods Retrospective study was made on the clinical data of 98 critical neonates who were treated with ventilator in our hospital＇s NICU in the latest 5 years. Results The incidence of VAP was 46. 94% ,and the gestational ages and the birth weights were negatively correlated, but the duration of MV, the times of intubation and MV were positively correlated （ P 〈 0. 01 ）. The main pathogens were opportunistic drug-resistant bacteria, and mostly were G^＋ bacilli （80. 39% ）, then G ^＋ cocci （ 13.73% ） ;2 strains of fungi were found in the cases of repeated MV ;complicating with VAP or not had a significant effect on the cure rate （ P 〈 0.05 ）. Conclusion The incidence of VAP has a close correlation with the gestational ages, the birth weights, the duration of MV, and the times of intubation and MV. The main pathogens are drug-resistant opportunistic bacteria;integrated prevention and treatment are very important.

关 键 词：新生儿 呼吸机相关性肺炎 高危因素 防治 

分 类 号：R72[医药卫生—儿科]