气管内冲洗在新生儿呼吸机相关肺炎中的应用  

Application of endotracheal lavage in neonatal ventilator-associated pneumonia

作　　者：林新祝 欧阳长安 赖基栋 李雅丹 郑直 

机构地区：[1]厦门市妇幼保健院新生儿重症监护室,福建厦门361000

出　　处：《中国当代儿科杂志》2010年第3期195-197,共3页Chinese Journal of Contemporary Pediatrics

摘　　要：目的探讨气管内冲洗技术在新生儿呼吸机相关肺炎(VAP)中的应用。方法将2002年1月至2008年12月新生儿VAP58例,随机分为对照组29例,冲洗组29例。两组撤机后,根据痰培养及药敏结果给予敏感抗生素治疗并加强对症支持处理。冲洗组在对照组治疗的基础上,应用气管内冲洗治疗,每日2～3次。对两组的治疗效果进行比较。结果对照组平均机械通气时间与冲洗组差异无统计学意义;对照组治疗有效率为69%,冲洗组为93%,差异有统计学意义(P<0.05);对照组二次或多次上呼吸机比例为24%,冲洗组为3%(P<0.05);冲洗组冲洗后2h的血气分析结果明显优于冲洗前(P<0.01)。结论气管内冲洗可以减少患儿机械通气的次数,提高治疗有效率,值得临床推广应用。Objective To study the efficacy of endotracheal lavage in neonatal ventilator-associated pneumonia （VAP）.Methods Fifty-eight neonates with VAP between January 2002 and December 2008 were randomly assigned to two groups： lavage and control （n=29 each）. After withdrawal from ventilator, both groups received sensitive antibiotics therapy according to sputum culture results as well as supportive treatment. The lavage group was additionally treated with endotracheal lavage （2-3 times daily）. The therapeutic effects were compared between the two groups.Results There were no significant differences in the average time of mechanical ventilation between the lavage and the control groups. The effective rate in the lavage group （93%） was significantly higher than that in the control group （69%; P0.05）. Three percent of patients in the lavage group required twice or more mechanical ventilation compared with 24% in the control group （P0.05）. Blood gas analysis results were obviously improved in the lavage group 2 hrs after treatment （P0.01）. Conclusions Endotracheal lavage can decrease the number in mechanical ventilation and improve therapeutic effects in neonates with VAP.

关 键 词：呼吸机相关肺炎 机械通气 新生儿 

分 类 号：R722.1[医药卫生—儿科]