新生儿呼吸机相关性肺炎的临床分析  

The Analysis of Neonate Mechanical Ventilation Associating with Pneumonia

作　　者：易阳[1] 钟闻燕[1] 张正霞[2] 

机构地区：[1]常州市儿童医院,常州213003 [2]温州医学院育英儿童医院呼吸科

出　　处：《临床急诊杂志》2007年第6期332-333,336,共3页Journal of Clinical Emergency

摘　　要：目的探讨新生儿呼吸机相关性肺炎(VAP)的治疗与预防方法。方法 66例(其中男41例,女25例)因呼吸衰竭上呼吸机时间大于48 h 的患儿均采用半卧位,经气管插管或气管切开导管吸痰。标本送实验室作革兰氏染色和细菌培养,同时作药敏试验。结果 66例患儿中17例发生 VAP,占25.8%。4例为多菌种混合感染,占23.5%。在17例 VAP 中治愈lO例,自动出院5例,死亡2例(包括肺出血1例,MODS 1例)。分离出病原菌25株,其中革兰氏阴性杆菌21株(84%),依次为大肠埃希氏菌、肺炎克雷白杆菌、阴沟肠杆菌等。结论新生儿呼吸机相关性肺炎主要病原菌为大肠埃希氏菌、肺炎克雷白杆菌、阴沟肠杆菌、不动杆菌等革兰氏阴性杆菌。Objective To study the treatment and prevention of neonate mechanical ventilation associating pneumonia（VAP）. Methods The sputums were suetioned through tracheal canula or the trueheostomy tube in 66 patients who were treated with mechanical ventilator . The suetioned sputum were send for culture. Results Among 66 patient, 17 patients had mechanical ventilation associating with pneumonia （25.8%） ,4 patient had polyinfection, （23.5%）. Among 17 cases of VAP,10 cases were recoved after treatment, while 5 cases gave up to treat,other two cases died of palmonary hemorrhage and multiple organs deficiency syndrome（MODS）. The main bacteria in eueture were Gram-negative bieillas such as large intestinal bocillus, pneumonia bacillus, sewer bowel bacillus, umoved bacillas. Conclusion The main bacillus in neonate mechanical ventilation associating pneumonia were large intestine bacillus, pneumonia bacillus, sewer bowel bacillus unmoved bacillus.

关 键 词：新生儿 呼吸机相关性肺炎 

分 类 号：R722.13[医药卫生—儿科]