ICU呼吸机相关性肺炎的危险因素及防治措施分析  

Analysis of Risk Factors and Preventive Measures of Ventilator-associated Pneumonia in ICU

作　　者：李秀波[1] LI Xiubo(Department of Intensive Care Unit,Taian Enliang Hospital,Anshan 114100,China)

机构地区：[1]辽宁省鞍山市台安县恩良医院重症监护室,辽宁鞍山114100

出　　处：《中国医药指南》2020年第23期112-113,共2页Guide of China Medicine

摘　　要：目的分析探讨重症加强护理病房(ICU)呼吸机机械通气的患者发生呼吸机相关性肺炎的危险因素及防治措施。方法回顾性分析2013年1月至2018年1月在我科住院并接受呼吸机机械通气的174例患者的临床资料,统计呼吸机相关性肺炎的发生情况,并对患者的性别、年龄、机械通气时间、合并疾病、白蛋白水平、药物使用情况、有无胃内容物反流等情况进行分析,同时通过痰液细菌培养分离鉴定病原菌,探讨防治呼吸机相关性肺炎的最佳措施。结果174例患者中59例出现呼吸机相关性肺炎。年龄、机械通气时间、合并糖尿病、白蛋白水平低、预防使用抗生素和抑酸药物、胃内容物反流是导致呼吸机机械通气患者发生呼吸机相关性肺炎的危险因素。结论呼吸机机械通气患者发生呼吸机相关性肺炎的概率较高且危险因素多,临床应提前做好预防工作,当患者发生感染后针对病因进行治疗能提高临床疗效;致病菌的分离和药敏试验的测定有助于临床抗生素的准确选择。Objective To analyze and explore the risk factors and preventive measures of ventilator-associated pneumonia in patients with ventilator mechanical ventilation in the intensive care unit(ICU).Method The clinical data of 174 patients who were hospitalized in our department from January 2013 to January 2018 and received mechanical ventilation were retrospectively analyzed.The incidence of ventilator-associated pneumonia was statistically analyzed.The gender,age,duration of mechanical ventilation,comorbidities,albumin level,drug use,and reflux of gastric contents were analyzed.At the same time,sputum bacteria culture is used to isolate and identify pathogenic bacteria,and to explore the best measures to prevent and treat ventilatorrelated pneumonia.Results Among 174 patients,59 cases had ventilator-associated pneumonia.Age,duration of mechanical ventilation,diabetes mellitus,low albumin level,prophylactic use of antibiotics and anti acid drugs,gastric reflux are risk factors for ventilator-associated pneumonia in patients with mechanical ventilation.Conclusion Ventilator-associated pneumonia in patients with mechanical ventilation has a high probability and many risk factors.Prevention work should be done in advance in clinical practice.When patients have infection,treatment according to the etiology can improve the clinical efficacy;the isolation of pathogenic bacteria and the determination of drug sensitivity test are helpful to the accurate selection of clinical antibiotics.

关 键 词：呼吸机相关性肺炎 重症加强护理病房 危险因素 防治措施 

分 类 号：R563.1[医药卫生—呼吸系统]