心脏外科ICU呼吸机相关性肺炎危险因素分析  

Risk factors for ventilator-associated pneumonia in ICU of department of cardiac surgery

作　　者：周立芹[1] 李树彦[1] 高春枝[1] 

机构地区：[1]河北唐山工人医院心脏外科监护室,河北唐山063000

出　　处：《中华医院感染学杂志》2014年第5期1223-1224,1246,共3页Chinese Journal of Nosocomiology

基　　金：唐山市科学技术研究与发展计划指导基金项目(10320308)

摘　　要：目的探讨心脏外科ICU患者发生呼吸机相关性肺炎的危险因素,为其临床防治提供依据。方法回顾性调查120例入住医院心脏外科ICU患者的临床资料,记录全部患者的基本信息;根据其是否发生呼吸机相关性肺炎分为感染组与未感染组,应用多因素回归分析进行多因素分析。结果 120例ICU患者中有20例发生呼吸机相关性肺炎,发生率为16.7%;单因素分析结果显示:年龄≥60岁、昏迷、患有慢性阻塞性肺疾病、糖尿病史、白蛋白水平及住院时间与呼吸机相关性肺炎的发生存在相关性,两组比较差异有统计学意义(P<0.05);多因素分析结果表明:年龄≥60岁、患有慢性阻塞性肺疾病、白蛋白水平低下及住院时间延长是呼吸机相关性肺炎发生的独立危险因素(P<0.05)。结论心脏外科ICU呼吸机相关性肺炎的发生随着患者年龄的增加、白蛋白水平的低下及住院时间的较长,其发生率较高,在临床工作中对该类危险因素需进行必要的干预。OBJECTIVE To explore the risk factors for ventilator-associated pneumonia （V AP） in the leU of department of cardiac surgery so as to provide guidance for clinical prevention and treatment. METHODS The clinical data of 120 patients who were hospitalized the leU of department of cardiac surgery were retrospectively investigated, then the baseline information of all the patients was recorded, the subjects were divided into the infection group and the non-infection group according to the status of V AP, and the multivariate regression analysis was performed. RESULTS Of the 120 leU patients, the V AP occurred in 20 cases with the incidence rate of 16.7%. The result of univariate analysis showed that the more than 60 years of age, coma, chronic obstructive pulmonary disease, diabetes history, albumin level, and hospitalization duration were related to the incidence of V AP, the difference between the two groups was statistically significant （P 〈 0. 05）; the multivariate analysis indicated that the more than 60 years of age, low level of albumin, and prolonged hospitalization duration were the independent risk factors for V AP （P 〈 0. 05）. CONCLUSION The incidence of V AP in the leU patients of department of cardiac surgery increases with the increasing age, declined level of albumin, or prolonged hospitalization duration; it is necessary to take interventions to the risk factors during the clinical practice.

关 键 词：心脏外科 呼吸机相关性肺炎 危险因素 多因素分析 

分 类 号：R563.1[医药卫生—呼吸系统]