呼吸机相关性肺炎高危因素的临床探讨  

Clinical Study on High Risk Factors for Ventilator Acquired Pneumonia

作　　者：吴乃君[1] 常娅洁[1] 高岚[1] 韩巍[1] 

机构地区：[1]白求恩医科大学第一临床学院,长春130021

出　　处：《护理学杂志（综合版）》2000年第11期643-645,共3页Journal of Nursing Science

基　　金：吉林省卫生厅资助!项目(No.37)

摘　　要：为探讨呼吸机相关性肺炎 (VAP)的高危因素 ,对 ICU30例机械通气 (MV)病人行呼吸机管路及附属部件和病人气管深部分泌物的细菌培养。结果 :呼吸机使用前其管路及附件细菌培养均为阴性 ,使用中其管路及附件、病人气管深部细菌培养均有不同种类细菌生长 ,其中肠道菌属占 44 .2 % ;细菌阳性率随通气天数增加而增加。提示 :1使用前对呼吸机管路消毒方法有效 ;2诸多因素使肠道菌群经胃 -肺途径入肺致 VAP,再通过呼吸过程污染呼吸机管路 ;3当 MV≥ 5 d,VAP发生率高。据此提出缩短 MV时间 ,保持人工气道通畅 ,选择适当的营养方式 ,严格执行消毒隔离制度。In order to study the high risk factors for ventilator acquired pneumonia (VAP), 30 mechanical ventilation(MV) patients were analyzed by using bacteria cultivation of tubes,accessory parts and deep tracheal secretion. The results showed that bacteria cultivation is negative before use. Various kinds of bacteria grew in the use. The incidence of intestinal bacteria was 44 2%. The cultivation rate of bacteria increased with MV days prolonged. It was suggested that sterilization of ventilator before use was effective. Affected by many factors, intestinal bacteria were access to lung through stomach lung way to cause the occurrence of VAP and also polluted the tubes of ventilators through the process of ventilation. The occurrence rate of VAP was higher when MV≥5 d. Establishment of effective and practicable nursing strategy can not only prevent and reduce the occurrence of VAP, but also improve the survival rate of critically ill patients.

关 键 词：呼吸机相关性肺炎 高危因素 机械通气 ICU 

分 类 号：R563.1[医药卫生—呼吸系统] R605.973[医药卫生—内科学]