呼吸机相关性肺炎132例分析  

Analysis of 132 cases of ventilator associated pneumonia

作　　者：吴雪花[1] 王昌锋[1] 

机构地区：[1]黄冈市中心医院重症医学科,湖北黄冈438000

出　　处：《临床肺科杂志》2016年第6期1048-1050,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的分析进行机械通气的患者引起呼吸机相关性肺炎的危险因素,流行病学特点、病原菌耐药情况。方法选取在本院ICU进行机械通气患者362例(其中呼吸机相关性肺炎的患者132例),对其病例资料进行分析。结果 362例机械通气患者中,VAP感染有132例,感染率为36.46%;机械通气发生VAP感染的危险因素有抗生素使用种类>2种、机械通气时间≥7d、气管切开、年龄≥65岁,与相对应的项目比较,P均<0.001;132例患者共培养出菌株183株,其中革兰氏阴性杆菌129株(70.49%),革兰氏阳性菌30株(16.39%),真菌24株(13.11%),革兰氏阴性杆菌菌株与其他菌株比较,P<0.05。药敏监测,除对万古霉素、阿米卡星、亚胺培南(个别耐药)等药品不耐药外,对其他药品均有程度不同的耐药。结论本院进行机械通气的患者感染呼吸机相关性肺炎的几率较高,主要感染菌为革兰氏阴性杆菌,耐药情况较严重。Objective To analyze the risk factors of ventilator associated pneumonia in patients with me-chanical ventilation, and to analyze the epidemic characteristics and drug resistance of pathogenic bacteria. Methods 362 patients （132 patients with ventilator associated pneumonia） were selected from ICU, and the data were ana-lyzed. Results Among the 362 patients, 132 cases had VAP infection, and the infection rate was 36. 46%. The risk factors of VAP infection included antibiotic use category more than 2, mechanical ventilation time more than or e-qual to 7d, tracheotomy, and 65 years or older （P〈0. 001）. There were 183 cultured strains, including 129 strains of gram negative bacilli （70. 49%）, 30 strains of gram positive bacteria （16. 39%）, and 24 strains of fungi （13. 11%） . Gram negative bacilli strains showed significant difference with other strains （ P〈0. 05 ） . The monitoring of drug resistance showed it was resistant to many kinds of drugs, except vancomycin, amikacin, and imipenem. Con-clusion The risk of ventilator associated pneumonia in patients with mechanical ventilation is high, and the main in-fection bacteria is gram negative bacilli, and the drug resistance is serious.

关 键 词：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]