对机械通气患儿的呼吸机管路细菌学监测分析与护理  

Bacteriological monitoring of breathing circuit and nursing intervention on patients with mechanical ventilation

作　　者：黄梅花[1] 吴敏[2] 曾细秋[3] 陈运生[4] 

机构地区：[1]深圳市儿童医院供应室,518026 [2]深圳市儿童医院护理部,518026 [3]深圳市儿童医院PICU,518026 [4]深圳市儿童医院细菌室,518026

出　　处：《中华现代护理杂志》2008年第31期3271-3273,共3页Chinese Journal of Modern Nursing

摘　　要：目的研究呼吸机相关性肺炎（VAP）的高危因素及病原菌感染特征，为预防其引起的医院感染提供依据。方法对159例使用呼吸机患儿的呼吸机管路、下呼吸道感染病菌的菌株种类、呼吸机使用时间进行统计，分析与VAP发病的相关因素。结果呼吸机管路和下呼吸道病原菌构成比基本相同，依次为铜绿假单孢、嗜麦芽寡养单孢菌、鲍氏不动杆菌等。VAP的发病率为37．7％。使用呼吸机时间长短与VAP发病率呈正相关（P〈0．01）。结论VAP的发生与多种临床因素有关，使用时间越长，发病率越高。为控制感染，须加强各环节护理质量监控，同时对呼吸机管路采取有效的消毒灭菌方法至关重要。Objective To investigate the high risk factors and etiology character of ventilator-associated pneumonia （VAP） and provide the guidance for preventing and nursing the nosocomial infection. Methods 159 children who have undergone therapy of mechanical ventilation, The pathogens which came from both breath circuit and low respiratory airway have been statistically analysed. The relationships have been observed among relative factors of strains, the lasting time of mechanical ventilation and VAP. Results There were the same constructional ratios of pathogen between breath circuit and low respiratory airway. The ratios from high to low were Pseudomonas aeruginosa, Stenotrophomonas mallophilia, Acinetobacter and so on respectively. The morbidity of VAP was 37.7%. The time of mechanical ventilation assisted has stated a significant relationship with occurrence of VAP. Conclusions The occurrence of VAP is related with multiple clinical factors. The more assisted time, and the higher incidences. The active measures must be carried out so as to control infection effectively. The nursing intervention should be advanced from all aspects, especially paying attention to sterilizing and managements of the breathing circuit. All of the this are very important.

关 键 词：机械通气 呼吸机相关性肺炎 病原菌 护理对策 

分 类 号：R473.72[医药卫生—护理学]