新生儿机械通气相关性肺炎危险因素探讨  

Analysis of the risk factors for neonatal ventilator-associated pneumonia

作　　者：吴华[1] 李向荣[1] 陈晓芸[1] 

机构地区：[1]南方医科大学附属深圳市宝安人民医院儿科,518101

出　　处：《中国小儿急救医学》2010年第1期20-22,共3页Chinese Pediatric Emergency Medicine

摘　　要：目的探讨新生儿机械通气相关性肺炎（VAP）的危险因素。方法回顾分析我院82例行机械通气辅助治疗的新生儿发生VAP的临床情况，采用Logistic多元回归分析方法探讨新生儿发生VAP可能的危险因素。结果Logistic多元回归分析表明有统计学意义（P〈0．05）的危险因素有胎龄（OR=6．209，95％CI=2．112—16．835）、机械通气时间（OR=5．842，95％CI=1．366—14．936）、气管内吸引次数（OR=4．764，95％CI=1．416—14．736）、再插管（OR=6．190，95％CI=1．669～16．019）、留置胃管（OR=6．794，95％CI=1．928～19．160）、应用中枢抑制剂（OR=4．297，95％CI=1．002—15．216）。结论新生儿VAP的发生是多因素的综合作用结果，出生时胎龄小、机械通气时间长、气管内吸引次数多、再插管、留置胃管、应用中枢抑制剂是新生儿发生VAP的危险因素。Objective To explore the risk factors of ventilator-associated pneumonia （VAP） in neonatal patients. Methods A retrospective study was conducted on the 82 neonates who had ever received me- chanical ventilation for more than 48 hours, non-conditional logistic regression analysis was performed to determine independent predictors for VAP. Results By logistic regression analysis, the following risk factors independently predicted VAP： gestational age （ OR = 6. 209,95 % CI = 2. 112 - 16. 835 ）, duration of mechanical ventilation （ OR = 5.842,95 % CI = 1.366 - 14. 936）, times of endotracheal suctioning （ OR = 4. 764,95% CI = 1.416 - 14. 736 ）, re-intubation （ OR = 6. 190,95 % CI = 1. 669 - 16.019 ）, gastric tubes retention （ OR = 6. 794,95% CI = 1. 928 - 19. 160 ）, treartment with CNS suppressant （ OR = 4. 297,95% CI = 1.002 - 15.216）. Conclusion The neonatal VAP occoured for multiple facors, the rsik factors include gestational age, duration of mechanical ventilation, endotracheal suctioning, re-intubation, gastric tubes retention and treatment with CNS suppressant.

关 键 词：新生儿 机械通气相关性肺炎 危险因素 

分 类 号：R722.1[医药卫生—儿科]