重症肌无力患者呼吸机相关性肺炎的预防策略及临床分析  

Causes of ventilator-associated pneumonia in myasthenia gravis patients and prevention countermeasures

作　　者：邓石凤[1] 黄贤丽[2] 张小燕[2] 彭雪梅[1] 刘卫彬[1] 

机构地区：[1]中山大学附属第一医院神经内科,广东广州510080 [2]中山大学附属第一医院护理部,广东广州510080

出　　处：《中华医院感染学杂志》2013年第15期3609-3610,共2页Chinese Journal of Nosocomiology

摘　　要：目的探讨重症肌无力患者呼吸机相关性肺炎(VAP)发生的相关因素及预防措施,以降低VAP发生率。方法 2009年10月-2012年10月医院诊治的12例重症肌无力并发VAP患者,探讨其相关因素及预防措施,对其临床资料进行回顾性分析。结果重症肌无力并发VAP的发生率为10.0%,随着上机时间和肾上腺皮质激素应用时间的延长,其发生率明显增高,两种抗菌药物联合预防性应用时,其VAP并发率最低为6.0%,病原菌培养以假单胞菌属为主占45.5%。结论针对相关因素,做好病房消毒、呼吸机管理、定时气道湿化、预防并发症等护理工作,严格无菌操作、正确吸痰技术、防止交叉感染等,能有效预防重症肌无力患者并发呼吸机相关性肺炎的发生。OBJECTIVE To study the related factors and prevention measures for the myasthenia gravis patients with ventilator-associated pneumonia （VAP） so as to reduce the incidence of VAP. METHODS Twelve myasthenia gravis patients with ventilator-associated pneumonia in our hospital during the period from Oct 2009 to Oct 2012 were researched the related pathogenic factors and prevention measures, and the clinical data were retrospectively analyzed. RESULTS The incidence of complicated VAP was 10.0%. This incidence was elevated with the exten- sion of time of application of ventilator or the adrenal corticosteroids. The incidence of complicated VAP was the lowest （6.0%） when two antibiotics were preventively applied. The pathogens culture results showed that the pseudomonas were predominant （45.5 %）. CONCLUSION For the related factors, the prevention measures such as the good ward disinfection, ventilator management, timing airway humidification and the complications preven- tion, strict aseptic technique, correct suction, and prevention of cross-infection can effectively prevent VAP in the myasthenia gravis patients.

关 键 词：重症肌无力 呼吸机相关性肺炎 发生率 预防 

分 类 号：R563.1[医药卫生—呼吸系统]