重症监护病房机械通气相关性肺炎危险因素研究  

Study on Risk Factors of Ventilator-associated Pneumonia in Intensive Care Unit

作　　者：王斌[1] 林乐清[1] 张烛仙[1] 

机构地区：[1]杭州师范大学附属医院重症医学科,杭州310015

出　　处：《浙江中西医结合杂志》2011年第7期456-457,460,共3页Zhejiang Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:探讨我院重症监护病房机械通气相关性肺炎(VAP)的危险因素,为制定相应的防治措施提供依据。方法:以2005年1月—2009年12月在我院重症监护室(ICU)接受气管插管或气管切开的患者为研究对象,采用病例-对照的研究方法探索VAP发病的可能危险因素。结果:共收集到患者453例,发生VAP229例,发生率为50.55%,多因素logistic回归分析显示抗生素合用、重复气管插管、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分过高及机械通气时间延长为VAP的危险因素,OR值分别为6.58、5.32、3.57及1.14,均有统计学意义(P<0.05,P<0.01)。结论:多个因素导致ICU发生VAP,其中以抗生素合用、重复气管插管表现最为突出。To explore the risk factors of ventilator-associated puenmonia （VAP） in intensive care unit. Methods： Subjects were patients treated with endotracheal intubation or tracheostomy in intensive care unit of our hospital from January 2005 to December 2009. A case-control method was used to explore the risk factor for developing VAP. Results： A total of 453 patients were included in the present study, with a VAP incidence of 50.55%（229 patients）. Multi-logistic regres sion analysis showed combination of antibiotics, repeated intubation, high APACHE Ⅱ , and long mechanical ventilation were risk factor of VAP, with significant OR of 6.58, 5.32, 3.57, and 1.14, respectively. Conclusion： Many risk factors can induce VAP in intensive care unit, among which combination of antibiotics and repeated intubation may be the main factors.

关 键 词：机械通气相关肺炎 危险因素 病例-对照研究 

分 类 号：R563.1[医药卫生—呼吸系统]