ICU患者应用呼吸机致呼吸道感染相关性分析  

Correlation between the use of ventilator and the respiratory tract infections in ICU patients

作　　者：刘鹏[1] 许兆军[1] 杨群[1] 张玉楚[1] 

机构地区：[1]宁波市第二医院重症医学科,浙江宁波315010

出　　处：《中华医院感染学杂志》2013年第14期3324-3326,共3页Chinese Journal of Nosocomiology

基　　金：宁波市科技计划项目(2011C50060)

摘　　要：目的为了进一步探讨ICU患者应用呼吸机后呼吸道感染的相关因素,为临床预防呼吸道感染提供有效依据。方法选取2011年1-12月医院收治的ICU患者为研究对象,针对患者的临床资料进行回顾性分析。结果 465例患者中发生呼吸道感染168例,感染率为36.13%;患者基础疾病数量为1～4种时的感染率分别为24.00%、34.54%、51.28%、75.61%,显示随着患者基础疾病数量的增加,患者呼吸道感染的比例不断升高,各组间逐级比较,差异均有统计学意义(P<0.05);患者带机时间为≤3、4～7、8～14、≥15d时的感染率分别为10.37%、43.68%、68.18%、84.51%,显示随着患者带机时间的不断增加,患者呼吸道感染的比例不断升高,各组间逐级比较,差异均有统计学意义(P<0.05);同时,采用声门下吸引感染率为28.21%,采用无创通气感染率为21.28%,均低于不采用者,组间比较,差异均有统计学意义(P<0.05)。结论对于ICU患者来说,应用呼吸机呼吸道感染的发病比例与患者基础疾病的数量、呼吸机通气时间等因素相关,在临床实践中应通过有效的措施来降低患者呼吸道感染的发生。OBJECTIVE To further explore the related factors of respiratory tract infections in the ICU patients after use of ventilator so as to provide basis for effective prevention of respiratory tract infections.METHODS The ICU patients who were treated in the hospital from Jan to Dec 2011 were included as the study subjects,then the clinical data of the patients were retrospectively analyzed.RESULTS Of 465cases of patients investigated,the respiratory tract infections occurred in 168 patients with the infection rate of 36.13%.The infection rate of the patients with one kind of underlying disease 24.00%,the patients with two kinds of underling diseases 34.54%,the patients with three kinds of underling diseases 51.28%,the patients with four kinds of underlying diseases 75.61%,indicating that with the increase of the number of patients with underlying diseases,the proportion of patients with respiratory tract infections were rising,the difference was statistically significant（P0.05）.The infection rate of the patients with the time of use of ventilator less than 3hours was 10.37%,the patients with the time of use of ventilator varying between 4and 7hours 43.68%,the patients with the time of use of ventilator varying between 8and 14hours 68.18%,the patients with the time of use of ventilator more than 15hours 84.51%,indicating that with the increase of time of use of ventilator,the proportion of patients with respiratory tract infections were rising,the difference was statistically significant（P0.05）.The infection rate of the patients who took the subglottic suction was 28.21%,the patients who took the non-invasive ventilation 21.28%,both of which were lower than those who did not take any measure,the difference was statistically significant（P 0.05）.CONCLUSIONFor the ICU patients,the incidence of the ventilator-associated respiratory tract infections is related to the number of underlying diseases and the time of mechanical ventilation.In the clinical practice,we should adopt effective measures to reduce the inc

关 键 词：呼吸机 呼吸道感染 相关性 

分 类 号：R181.32[医药卫生—流行病学]