小儿呼吸机相关肺炎的预防和护理  

Prevention and nursing in ventilator-associated pneumonia of pediatric patients

作　　者：李海霞[1] 张天美[1] 

机构地区：[1]河南省新乡市中心医院儿科,河南新乡453000

出　　处：《中国医药导报》2009年第11期90-92,共3页China Medical Herald

摘　　要：目的:分析小儿呼吸机相关肺炎(VAP)的主要致病因素,从护理的角度探讨预防VAP的措施。方法:回顾性分析2006年9月～2008年5月我院使用呼吸机患儿的临床资料。结果:发生VAP51例,经过积极的治疗和精心的护理,治愈27例,死亡16例,8例放弃治疗。VAP发生率为42%,治愈率为53%。结论:VAP的发病机制主要包括病原菌侵袭机会增加和宿主免疫机制减弱两个方面。因此,应加强NICU消毒隔离制度;加强患儿的呼吸道管理,严格无菌操作,减少呼吸道感染的机会;加强呼吸机管道的管理和细菌学监测;加强营养,增强体质,提高患儿免疫力;加强基础护理,这些措施对于预防VAP的发生和降低VAP死亡率具有重要意义。Objective： To analyze the primary nosogenesises in ventilator-associated pneumonia （VAP） of pediatric patients, and discuss how to prevent VAP in the point of nursing. Methods： The clinical data of pediatric patients using breathing machine from September 2006 to May 2008 were retrospectively analyzed. Results： 51 patients occurred VAP, after active treatment and chary nursing, 27 patients were cured, 16 patients died and 8 patients gave up treatment. VAP incidence rate was 42%, and the cure rate was 53%. Conclusion： The pathogenesis of VAP has two states： the increase Of germ attacking opportunities and the weakening of patients＇ immunoreaction. Therefore, it is important to prevent VAP by strengthening disinfect and isolation of NICU and administration respiratory tract of patients, taking strict aseptic technique, decreasing opportunities of children respiratory tract infected, tightening breathing machine duct control and bacte-riological monitoring, putting emphasis on nutrition, improving health condition, enhancing patients＂ immunity and strengthening basic nursing.

关 键 词：小儿 呼吸机相关肺炎 预防和护理 

分 类 号：R473.72[医药卫生—护理学]