呼吸机相关性肺炎的危险因素研究  

The study of risk factors for ventilator-associated pneumonia

作　　者：张长春[1] 贾晓君[1] 张淑敏[1] 易玲娴[1] 

机构地区：[1]解放军306医院ICU,北京100101

出　　处：《临床急诊杂志》2014年第7期423-425,共3页Journal of Clinical Emergency

摘　　要：目的:研究机械通气患者发生呼吸机相关性肺炎(VAP)的危险因素。方法:回顾性分析2011-05-2013-05我院重症监护病房使用有创机械通气治疗的176例患者临床资料,对年龄、性别、血清白蛋白水平、营养方式、机械通气时间、APACHEⅡ评分、再次插管、气管切开、使用糖皮质激素、静脉使用镇静剂、置入中心静脉导管和使用质子泵抑制剂进行单因素分析,并对有统计学意义的因素进行Logistic多因素回归分析,探讨呼吸机相关性肺炎发生的危险因素。结果:气管切开、血清白蛋白≤30g/L、机械通气时间≥7d,APACHEⅡ评分≥20分,使用质子泵抑制剂是VAP发生的独立危险因素。结论:机械通气患者应加强营养,尽量避免气管切开,尽早脱机,尽量不使用质子泵抑制剂,减少呼吸机相关性肺炎的发生。Objective：To explore the risk factors for ventilator-associated pneumonia （VAP）. Method..A retrospective study was performed to investigate the possible risk factors for VAP in 176 patients who were admitted to ICU and received mechanical ventilation from May 2011 to May 2013. Result：Compared with their control groups, the patients had higher VAP incidence when Alb≤ 30 g/L, on mechanical ventilation ≥7 days, APACHE Ⅱ ≥20, tracheostomy and proton pumps inhibitors were used. The differences were significant. Conclusion： Patients with mechanical ventilation should improve their nutritional status, wean from mechanical ventilation as soon as possible,not use proton pumps inhibitors, avoidance of tracheostomy as far as possible,in order to cut down the VAP incidence.

关 键 词：呼吸机相关性肺炎 危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]