机械通气治疗患者管路细菌污染与呼吸机相关性肺炎发生情况分析  

Analysis of bacterial contamination of ventilator circuit and ventilator associated pneumonia in mechanical ventilation patients

作　　者：庄瑞强[1] 袁运生[1] 吴京兰[1] 林进团[1] 黎锐发[1] 肖水明[1] 张海钢[1] 

机构地区：[1]广东省深圳市南山区人民医院重症医学科,深圳市518052

出　　处：《内科》2017年第4期471-473,共3页Internal Medicine

基　　金：2012年深圳市科技计划项目(201203201)

摘　　要：目的分析呼吸衰竭患者在ICU病房行机械通气治疗时管路细菌污染与呼吸机相关性肺炎(VAP)发生的情况。方法选取2014年9月至2017年3月我院ICU病房收治的呼吸衰竭行机械通气治疗患者120例为研究对象,根据呼吸机管路细菌污染监测结果分为污染组与非污染组,通过比较两组患者一般情况、VAP的发生情况、病死率及机械通气时间、住院时间之间的差异,分析机械通气治疗患者管路细菌污染与呼吸机相关性肺炎(VAP)发生的相关性。结果呼吸衰竭患者在ICU病房行机械通气治疗时,呼吸机管路细菌污染的发生率高达46.7%;污染组患者VAP发生率(21.43%)与病死率(17.86%)均显著高于非污染组(6.25%,4.69%),机械通气时间与住院时间也显著长于非污染组,差异均有统计学意义(P<0.05)。结论呼吸衰竭患者在ICU病房行机械通气治疗时管路细菌污染情况比较严重,呼吸机管路细菌污染会明显增加患者呼吸机相关性肺炎的发生率与死亡风险,延长机械通气时间与住院时间,必须予以足够的重视并及时进行干预。Objective To analyze the occurrence of bacterial contamination of ventilator circuit and ventilator-associated pneumonia （VAP） in patients with respiratory failure during mechanical ventilation therapy in ICU. Methods A total of 120 patients with respiratory failure who received mechanical ventilation therapy in ICU in our hospital from September 2014 to March 2017 were selected as study objects. The patients were divided into contaminated group and non-contaminated group according to the results of bacterial contamination monitoring of ventilator pipelines. The general condition, incidence of VAP, mortality rate, duration of mechanical ventilation and time of hospitalization were compared between the two groups, and then the relationship between bacterial contamination of ventilator circuit and ventilator-associated pneumonia （VAP） was analyzed. Results During mechanical ventilation therapy in ICU, the incidence of bacterial contamination of ventilator circuit was 46.7% in patients with respiratory failure . The incidence of VAP （21.43%） and mortality （ 17.86% ） in the contaminated group were significantly higher than those in the non-contaminated group （6.25% and 4.69% , respectively）, mechanical ventilation time and hospital stay in the contaminated group were significantly longer than those in non-contaminated group （P 〈 0. 05 ）. Conclusions Ventilator circuit is severely contaminated in patients with respiratory failure who under mechanical ventilation treatment, bacterial contamination of ventilator circuit could increase the incidence of VAP and mortality risk, and prolong duration of mechanical ventilation and hospitalization time, enough attention should be paid and timely intervention should be performed.

关 键 词：呼吸衰竭 机械通气 ICU病房 管路细菌污染 呼吸机相关性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]