呼吸衰竭患者呼吸机相关性肺炎的调查  

Risk factors for ventilator-associated pneumonia in patients with respiratory failure

作　　者：石新艳[1] 王虹[2] 王升英[3] 韩伟[4] 黄伟丽[5] 

机构地区：[1]青岛大学附属医院普通外科,山东青岛266003 [2]青岛市市立医院感染管理科,山东青岛266011 [3]青岛市市立医院骨科,山东青岛266011 [4]青岛市市立医院呼吸科,山东青岛266011 [5]青岛大学附属医院医院感染管理科,山东青岛266003

出　　处：《中华医院感染学杂志》2015年第17期3955-3956,3959,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81400024)

摘　　要：目的探讨呼吸衰竭患者诱发呼吸机相关性肺炎(VAP)感染的危险因素,为制定有效的预防控制措施提供依据。方法对2013-2014年医院呼吸衰竭患者发生的VAP感染患者进行回顾性调查分析;采用SPSS13.0软件对数据进行统计分析。结果 134例呼吸衰竭患者中发生VAP感染45例,感染率为33.58%;共分离病原菌65株,排前3位的分别为鲍氏不动杆菌、大肠埃希菌、铜绿假单胞菌;年龄、住院时间、基础疾病、侵入性操作、长时间应用免疫抑制剂与不合理使用抗菌药物是呼吸衰竭患者诱发VAP的危险因素(P<0.05)。结论降低VAP的发生率能有效提高呼吸衰竭患者的生存率,加强医院感染管理,减少侵入性诊疗操作与合理使用抗菌药物是降低VAP发生率的有效方法。OBJECTIVE To explore the risk factors for the ventilator-associated pneumonia（VAP）in the patients with respiratory failure so as to put forward effective prevention measures.METHODS The respiratory failure patients complicated with VAP who were treated from 2013 to 2014were retrospectively investigated,and the statistical analysis of data was performed with the use of SPSS13.0software.RESULTS The VAP occurred in 45 of 134patients with respiratory failure,with the incidence rate of 33.58%.A total of 65 strains of pathogens have been isolated;the Acinetobacter baumannii,Escherichia coli,and Pseudomonas aeruginosaranked the top three places.The risk factors for the VAP in the respiratory failure patients included the age,length of hospital stay,underlying disease,invasive operation,long-term use of immunosuppressants,and unreasonable use of antibiotics（P〈0.05）.CONCLUSIONThe reduction of the incidence of the VAP may effectively raise the survival rate of the patients with respiratory failure.It is an effective way to strengthen the control of nosocomial infections,reduce the invasive operations,and reasonably use antibiotics so as to reduce the incidence of the VAP.

关 键 词：呼吸衰竭 呼吸机相关性肺炎 危险因素 病原菌 

分 类 号：R563.1[医药卫生—呼吸系统]