新生儿重症监护室VAP危险因素及防控措施效果评价  

Risk factors of ventilator-associated pneumonia and evaluation of prevention and control measures in NICU

作　　者：李娜[1] 刘丽君[1] 冯艳萍[1] 李福琴[2] 杨阳[2] LI Na;LIU Li - jun;FENG Yah - ping;LI Fu - qin;YANG Yang(Department of Neonatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, Chin)

机构地区：[1]郑州大学第一附属医院新生儿科一病区,河南郑州450052 [2]郑州大学第一附属医院感染管理科,河南郑州450052

出　　处：《现代预防医学》2018年第11期2090-2093,共4页Modern Preventive Medicine

基　　金：河南省科技攻关计划项目(162102310155)

摘　　要：目的了解新生儿重症监护室(NICU)呼吸机相关肺炎(VAP)发生危险因素,制定针对性集束化干预措施,并评价VAP干预措施效果。方法选取郑州大学第一附属医院2015年12月-2016年12月NICU使用呼吸机患儿2 564例作为研究对象,采用Logistic回归分析患儿VAP发生危险因素。根据上述危险因素制定VAP防控措施,选择呼吸机使用患儿400例,对照组和试验组各200例,对照组常规护理,试验组在此基础上实施VAP集束化干预措施,比较两组VAP千日感染率、平均住院时间及平均住院费用。结果本院NICU早产儿、极低出生体重儿、机械通气时间为VAP发生的独立危险因素。集束化措施干预后,与对照组相比,试验组的VAP千日感染率、平均住院时间及平均住院费用均明显下降,差异有统计学意义(P<0.05)。结论分析NICU患儿VAP发生危险因素,制定集束化干预措施,可有效控制VAP发病率,减少NICU住院时间,降低住院费用,保障患儿诊疗安全。Objective To analyze the risk factors of ventilator - associated pneumonia （VAP） infection in neonatal intensive care unit （NICU）, and to develop targeted intervention measures and evaluate the effect of VAP prevention and control measures. Methods From Dec 2015 to Dec 2016, a total of 2 564 children with a ventilator in NICU in the First Affiliated Hospital of Zhengzhou University were enrolled in this study. Risk factors of the muhidrug - resistant organism were analyzed by logistic regression. According to the above risk factors to develop prevention and control measures of VAP. 400 children with ventilator were selected and divided into control group （ 200 cases ） and routine test group （ 200 cases ）. The test group was treated with VAP, and the control group was treated usually. Two groups of VAP infection rate, the average length of stay and the average hospital costs were compared. Results Risk factors of VAP in preterm infants were premature children,very low birth weight and ventilator use time. Compared with the control group, the incidence of VAP, duration of neonatal and hospital costs of the experimental group were significantly lower than those of the control group （ P 〈 0.05 ）. Conclusion It is necessary to establish VAP - related risk factors and develop a cluster of interventions, which can effectively prevent from VAP, reducing NICU hospital stay and hospital costs, and to improve medical treatment and safety.

关 键 词：新生儿重症监护室 呼吸机相关肺炎 危险因素 集束化干预措施 

分 类 号：R181.32[医药卫生—流行病学]