重症监护病房呼吸机相关性肺炎原因分析与管理对策  

Ventilator associated pneumonia in intensive care unit:the causes and countermeasures

作　　者：刘荘美[1] 杨红秀[1] 

机构地区：[1]湖南省第二人民医院消毒供应中心,湖南长沙410007

出　　处：《中华医院感染学杂志》2011年第7期1319-1321,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨ICU呼吸机相关性肺炎(VAP)的发病原因和干预措施。方法以283例住院>48 h接受机械通气(MV)患者为调查对象,对其临床资料、病原菌分布特点作回顾性分析。结果并发VAP有56例,发病率为19.79%,共检出病原菌189株,其中革兰阴性杆菌89株,占47.09%,革兰阳性球菌64株,占33.86%,下呼吸道分泌物共分离出104株,回路冷凝液共分离出85株,两组标本病原菌分布、构成比差异无统计学意义;发生与未发生VAP危险因素比较,差异有统计学意义(P<0.05)。结论 VAP的发生是多因素的综合,采取多种行之有效的干预措施,加强培训和监督,规范医疗和护理行为,注重医院感染控制,可预防和减少VAP的发病率,降低死亡率。OBJECTIVE To explore the causes and interventions of ventilator associated pneumonia（VAP） in ICU.METHODS A total of 283 patients with mechanical（MV） ventilation more than 48 hours were investigated,and a retrospective analysis on clinic data and pathogenic bacteria distribution characteristics was carried out.RESULTS The incidence of illness was 19.79%,56 patients with VAP.A total of 189 strains pathogens were found,among which Gram-negative bacilli 89 strains（47.09%）,Gram-positive bacilli 64 strains（33.86%）.104 strains were isolated from the secretion of lower respiratory,and 85 strains were isolated from the circuit condensate.The distribution and ratios were not significant by different between the two groups（P0.05）.There was signficant difference between the risk factors with VAP and without VAP（P0.05）.CONCLUSION Multi-factors attributed to delivering VAP.A variety of effective intervention measures should be taken,training and supervision should be reinforced,medical practice and nursing behaviors should be standardized,and at the same time we should attach great importance to hospital infection control,in this way we can prevent and reduce risk of VAP,as well as reduce the mortality.

关 键 词：呼吸机相关性肺炎 病原菌 危险因素 管理对策 

分 类 号：R181.32[医药卫生—流行病学]