ICU呼吸机相关性肺炎的病原菌及高危因素研究  

Study on pathogenic bacteria and high risk factors of ventilator-associated pneumonia in patients in ICU

作　　者：赵志海[1,2] 黄建安[1,2] 华文良[1,2] 姜健[1,2] 赵秀华[1,2] 朱涛[1,2] 

机构地区：[1]太仓市第一人民医院 [2]苏州大学附属太仓医院,江苏太仓215400

出　　处：《临床肺科杂志》2013年第3期468-470,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的对呼吸机相关性肺炎(VAP)的病原菌及高危因素进行分析。方法分析我院ICU收治的144例机械通气>48 h患者的临床资料。结果 40例符合VAP的诊断标准。取得病原菌212株,其中革兰氏阴性菌84.4%,革兰氏阳性菌6.6%,真菌9.0%;本组病原菌中前三位为鲍曼不动杆菌,铜绿假单胞菌,肺炎克雷白杆菌。患者的年龄,长时间机械通气,意识障碍,急慢性肺部疾病,镇静剂,抑酸剂,留置胃管为VAP的高危因素。结论 VAP的病原菌以革兰氏阴性杆菌为主,VAP的发生和多种危险因素有关。Objective To analysis the features of pathogens and high risk factors of VAP in ICU. Methods 144 cases received mechanical ventilation over 48h in ICU were respectively analyzed. Results 40 cases met the diagnosis criteria of VAP. 212 strains of bacteria were isolated, among which the gram-negative bacteria was 84.4%, the gram-positive bacteria was 6.6%, the fungi was 9.0%. The leading pathogens were acinetobacter baummannii, pseudomonas aeruginosa and klebsiella pneumoniae. The high risk factors associat- ed with VAP were age of patients, mechanical ventilation over 7 days, disturbance of consciousness, acute or chronic lung disease, seda- tives, acid inhabitor and indwelling nasogastric tube. Conclusion Gram-negative bacteria are the main pathogens of VAP in general ICU. The occurrence of VAP is related with multiple risk factors.

关 键 词：呼吸机相关性肺炎 病原菌 高危因素 

分 类 号：R563.1[医药卫生—呼吸系统]