冠脉搭桥术患者集束化干预措施预防控制呼吸机相关性肺炎效果观察  

Effect of cluster intervention measures on prevention of ventilator-associated pneumonia in patients undergoing coronary artery bypass grafting

作　　者：石新艳[1] 王虹[2] 刘志梅[3] 王升英[4] 韩伟[5] 黄伟丽[6] 

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]青岛市市立医院护理部,山东青岛266011 [4]青岛市市立医院骨科,山东青岛266011 [5]青岛市市立医院呼吸科,山东青岛266011 [6]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》2016年第21期4922-4924,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解冠脉搭桥术患者呼吸机相关性肺炎的分布,探讨诱发呼吸机相关性肺炎的危险因素,为预防冠脉搭桥术后呼吸机相关性肺炎发生提供参考依据。方法对2015年1月-10月56例冠脉搭桥术患者发生的呼吸机相关性肺炎病例进行回顾性调查分析,统计冠脉搭桥术患者呼吸机相关性肺炎的发生率与时间分布。结果56例冠脉搭桥术患者中发生呼吸机相关性肺炎感染11例;呼吸机相关性肺炎感染发生率19.64%,呼吸机相关性肺炎千日感染率为18.58‰;感染患者分离病原菌16株,排名前3位的分别为鲍氏不动杆菌、金黄色葡萄球菌、白色念珠菌;插管时间、声门下分泌物吸引是呼吸机相关性肺炎的危险因素。结论降低呼吸机相关性肺炎的发生率能有效提高冠脉搭桥术患者的生存率,加强医院感染管理、减少侵入性诊疗操作与声门下分泌物吸引是降低呼吸机相关性肺炎的有效方法。OBJECTIVE To understand the distribution of coronary artery bypass grafting patients with ventilator- associated pneumonia （VAP） and explore the risk factors for the VAP so as to provide guidance for prevention of VAP in the patients undergoing the coronary artery bypass grafting. METHODS From Jan 2015 to Oct 2015, a total of 56 patients who received the coronary artery bypass grafting and had VAP were retrospectively investigated. The incidence of VAP and time distribution of the coronary artery bypass grafting patients were statistically ana- lyzed. RESULTS Of the 56 patients undergoing the coronary artery bypass grafting, 11 had VAP; the incidence of VAP was 19.64%, the thousand-day infection rate of VAP was 18.58%0. Totally 16 strains of pathogens were i- solated from the patients with the infection; the Acinetobacter baumannii , Staphylococcus aureus, and Candida albicans ranked the top 3 species. The risk factors for the VAP included the catheter indwelling time and subglot- tic secretions suction. CONCLUSION The reduction of incidence of VAP may effectively raise the survival rate of the coronary artery bypass grafting patients. It is an effective way to strengthen the management of nosocomial in- fection and reduce the invasive operations as well as the subglottic secretions suction so as to reduce the incidence of VAP.

关 键 词：冠脉搭桥术 呼吸机相关性肺炎 危险因素 病原菌 分析 

分 类 号：R563.1[医药卫生—呼吸系统]