儿科ICU呼吸机相关肺炎的影响因素分析  

Analysis of influencing factors of ventilator-associated pneumonia in pediatric intensive care unit

作　　者：林秋玉[1] 李文琳[1] LIN Qiu-yu;LI Wen-lin(Hainan Maternal and Child Health Care Hospital,Haikou,Hainan　570000,China)

机构地区：[1]海南省妇幼保健院,海南海口570000

出　　处：《临床肺科杂志》2018年第2期330-333,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨儿科ICU呼吸机相关肺炎的影响因素。方法选取持续机械通气超过48h的100例患儿作为研究对象,根据最终是否发生VAP分为VAP组和非VAP组,各50例。对两组患儿的一般资料(性别、起病时间和死亡率)、基础疾病(机械通气前的肺部感染、先天性心脏病、坏死性肠炎、肺出血、脓毒症和呼吸窘迫综合征)和VAP相关影响因素(机械通气的持续时间、气管插管的次数、气管内吸引的次数、外科手术、肠道外营养以及ICU住院时间)进行比较;对其中有差异性的指标,通过Logistic回归分析,最终找出PICU患儿发生呼吸机相关肺炎的独立危险因素。结果 VAP组和非VAP组患儿各项基础疾病均未见显著差异(均P>0.05),无统计学意义;VAP组和非VAP组患儿机械通气的持续时间、气管插管的次数、气管内吸引的次数、肠道外营养以及ICU住院时间存在差异(均P<0.05),具有统计学意义;Logistic回归分析显示,胎龄、出生体重、肠道外营养、机械通气的持续时间、气管插管的次数、气管内吸引的次数和ICU住院时间是导致儿科ICU患儿出现VAP的独立危险因素(均P<0.05)。结论肠道外营养、机械通气的持续时间过长、重复气管插管、多次气管内吸引和ICU住院时间过长是导致儿科ICU患儿出现VAP的独立危险因素。Objective To explore the influencing factors of ventilator-associated pneumonia in pediatric intensive care unit.Methods 100 children with continuous mechanical ventilation for more than 48 hours inpediatric intensive care unit in our hospital from March 2015 to March 2017 were selected as the subjects.According to VAP they were divided into the VAP group and the non-VAP group,50 cases in each group.General information(gender,onset time and mortality),basic diseases(pulmonary ventilation before mechanical ventilation,congenital heart disease,necrotizing enteritis,pulmonary hemorrhage,sepsis Disease and respiratory distress syndrome)and VAP-related influencing factors(duration of mechanical ventilation,number of tracheal intubation,number of tracheal aspirations,surgery,parenteral nutrition,and ICU stay time)were compared between the two groups.The independent risk factors for ventilator-associated pneumonia in children with PICU were analyzed by Logistic regression analysis.Results (1)The mortality of the VAP group was significantly higher than that of the non-VAP group(P<0.05),the children with premature infants and birth weight<2500g were significantly higher in the VAP group than those in the non-VAP group(all P<0.05).(2)There was no significant difference in the basic diseases between the VAP group and the non-VAP group(all P>0.05).(3)There were significant differences in the duration of mechanical ventilation,the number of tracheal intubation,the number of tracheal aspiration,the parenteral nutrition and ICU stay(all P<0.05)between the two groups.(4)Logistic regression analysis showed that gestational age,birth weight,parenteral nutrition,duration of mechanical ventilation,number of tracheal intubation,number of tracheal aspirations and ICU stay were the independent risk of VAP in pediatric intensive care unit(all p<0.05).Conclusion The duration of parenteral nutrition,mechanical ventilation,repeated tracheal intubation,multiple tracheal aspiration and prolonged ICU hospitalization time are the independent r

关 键 词：儿科重症监护病房 呼吸机相关肺炎 影响因素 

分 类 号：R725.6[医药卫生—儿科]