Logistic回归分析医院内肺炎的危险因素  

Risk factors of hospital acquired pneumonia following Logistic regression analysis

作　　者：姜丽岩[1] 何礼贤[2] 李善群[2] 胡必杰[2] 赵守军[3] 

机构地区：[1]上海市胸科医院肺内科,200032 [2]上海医科大学中山医院肺病学教研室临床微生物和院内感染监控中心 [3]上海医科大学流行病教研室

出　　处：《中国急救医学》2000年第12期710-712,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的　研究手术相关医院内肺炎的危险因素。方法　采用病例对照研究的方法回顾性调查手术科室的医院内肺炎病例 ,Logistic回归分析其危险因素。结果　单因素分析发现下列因素与医院内肺炎的发生显著相关 :男性、年龄 6 0岁以上、入住ICU、全身免疫抑制 /严重疾病、气管 /气切插管且在 12小时以上、机械通气且时间超过 48小时、应用湿化系统、2月内曾有手术史、术中发生休克、留置导尿管、意识障碍、使用抗生素种类大于 3种且超过 3天、制酸剂 /H2 受体阻滞剂应用及使用时间超过 3天、手术时间超过 2小时、外科基础疾病为最终致死性疾病和快速致死性疾病、上腹部手术、全麻以及留置鼻胃管且留置时间超过 6小时。Logistic回归分析与肺炎发生高度相关的危险因素为 :高龄、留置鼻胃管超过 6小时、预防性抗生素和制酸剂 /H2 受体阻滞剂的应用以及有全身免疫抑制及严重的基础疾病。结论　高龄、留置鼻胃管、预防性抗生素和制酸剂 /H2 受体阻滞剂的应用 。Objective To investigate the risk factor of operative related hospital acquired pneumonia.Methods 210 patients admitted to Zhongshan hospital for surgery were included in our retrospective study.To investigate the risk factors of hospital acquired pneumonia used Logistic regression.ResultsMultiple regression analysis selected the following variables significantly associated with postoperative pneumonia:male,age≥60 years,the surgery intensive care unit,immunocompromised states/serious underlying disease,the presence of tracheo-intubation or tracheostomy and period longer than 12 hours,a mechanical ventilation period longer than 48 hours,the use of a cascade humidification system,prior surgery,shock in operation,location of catheter,persistence of consciousness,the kinds of antibiotic prophylactic therapy more than three and period longer than 3 days,treatment with antacids and /or H 2-receptor blocking and period longer than 3 days,period of surgery longer than 2 hours,the presence of an ultimately or rapidly fatal underlying disease,upper abdomen surgery,general anesthesia,the presence of nasogastric intubation and period longer than 6 hours.The factors high correlated with postoperative pneumonia analysis by Logistic analysis were:age≥60 years,the presence of nasogastric intubation≥6 hours,prophylaxis antibiotic therapy,administration of antacids and/or H 2-receptor blocking,immunocompromised states and serious underlying disease.Conclusion The risk factors high related with pneumonia were:age≥60 years,presence of nasogastric intubation≥6 hours,prophylaxis antibiotic therapy,administration of antacids and/or H 2-receptor blocking,immunocompromised states and serious underlying diseases.

关 键 词：危险因素 肺炎 医院内感染 LOGISTIC回归分析 

分 类 号：R563.1[医药卫生—呼吸系统]