小儿呼吸机相关性肺炎病原学及危险因素评价  

Evaluation of Etiology and Risk Factors of Ventilator-associated Pneumonia in Children

作　　者：邵楠 SHAO Nan(Department of Pediatrics,Maternal and Child Health Hospital of Qujing City,Qujing,Yunnan Province,655000 China)

机构地区：[1]云南省曲靖市妇幼保健院儿四科,云南曲靖655000

出　　处：《世界复合医学》2020年第7期40-42,46,共4页World Journal of Complex Medicine

摘　　要：目的探究小儿呼吸机相关性肺炎的病原学特征,并分析其危险因素。方法在该科数据库中选择时间段2017年10月—2019年5月间收入的所有接受小儿呼吸机治疗的患儿的一般资料,根据该次实验要求对患儿的一般资料进行分析,录入其中38例患儿开展实验,按照所有患儿是否发生呼吸机相关性肺炎将其分为健康组与肺炎组,每组中均录入19例患儿。对两组患儿的基础性疾病、呼吸机应用时间、气管插管次数、气管内吸引次数因素进行记录,分析两组之间差异。同时记录呼吸机相关性肺炎发生患儿中的病原菌感染状况,分析其中的构成比。结果肺炎组患儿的呼吸机应用时间较健康组明显更长(P<0.05),并且反复气管插管次数高于健康组[(6.4±1.2)次vs(2.6±0.5)次],组间差异有统计学意义(t=12.741,P=0.000)。但两组患儿中气管内吸引次数对比[(8.14±0.9)次vs(7.89±0.7)次],组间差异无统计学意义(t=0.956,P=0.346)。同时在38例接受呼吸机治疗的患儿中,其基础性疾病主要以重症肺炎为主,其他疾病主要包括先天性心脏病和手足口病并发病毒性脑炎,两组患儿病症发生基础疾病对比,数据分别为12例、4例、3例,12例、3例、4例,差异无统计学意义(χ^2=0.000、0.175、0.175,P=1.000、0.676、0.676)。而在所有发生肺炎的患儿中,受感染主要以革兰阴性菌为主,其中以肺炎克雷伯菌为主,其次为鲍曼不动杆菌以及其他革兰阴性菌。结论总体来说,呼吸机的应用时间和反复气管插管次数均会导致患儿的呼吸机相关性肺炎发病率升高,但气管内吸引次数不会对患儿的呼吸机相关性肺炎造成明显影响。同时患儿的基础性疾病也不会对患儿的呼吸机相关性肺炎发生率造成影响。所以在对小儿呼吸机相关性肺炎进行预防时,应当重视与呼吸机的应用时间和反复气管插管次数,这样才能有助于降低其发病率,达到良好的治疗Objective To explore the etiological characteristics of ventilator-associated pneumonia in children and analyze its risk factors.Methods Select the general data of all children who received pediatric ventilator treatment from October 2017 to May 2019 in thedatabase,analyze the general data of children according to the requirements of this experiment,and input 38 patients who carried out an experiment and divided them into a healthy group and a pneumonia group according to whether all children had ventilator-associated pneumonia.Each group included 19 children.The factors of the basic diseases,the application time of the ventilator,the number of intubation times,and the number of intratracheal suction times of the two groups of children were recorded,and the differences between the two groups were analyzed.At the same time,record the pathogen infection status in children with ventilator-associated pneumonia,and analyze the composition ratio.Results The patients in the Pneumonia group used the ventilator for a significantly longer time than the healthy group(P<0.05),and the number of repeated tracheal intubation was higher than that in the healthy group[(6.4±1.2)times vs(2.6±0.5)times].The difference between the groups was statistically significant(t=12.741,P=0.000).However,the number of intratracheal suction times in the two groups was not statistically significant difference between the groups[(8.14±0.9)times vs(7.89±0.7)times](t=0.956,P=0.346).At the same time,in 38 children who received ventilator treatment,the underlying disease was mainly severe pneumonia.Other diseases mainly included congenital heart disease and hand,foot and mouth disease with toxic encephalitis.The two groups of children suffered from basic diseases,the data were 12 people,4 people,3 people,12 people,3 people,4 people,the difference was not statisticallysignificant(χ^2=0.000,0.175,0.175,P=1.000,0.676,0.676).In all children with pneumonia,the main infections are mainly Gram-negative bacteria,among which Klebsiella pneumoniae is the ma

关 键 词：小儿呼吸机相关性肺炎 病原学 危险因素 因素分析 

分 类 号：R72[医药卫生—儿科]