呼吸窘迫综合征极低和超低出生体重早产儿呼吸机相关性肺炎临床分析  

Clinical analysis of Ventilator-associated pneumonia in children with very low/ultra-low birth weight respiratory distress syndrome

作　　者：刘玉娟[1] 楚艳艳[2] 李丽红[3] 王秀明[4] 冯子鉴[5] 谢文玉 LIU Yujuan;CHU Yanyan;LI Lihong;WANG Xiuming;FENG Zijian;XIE Wenyu(Supply Room,Weifang Maternal and Child Health Hospital,Weifang 261011,China;Science and Education Department,Weifang Maternal and Child Health Hospital;Department of Pediatrics,Weifang Maternal and Child Health Hospital;Laboratory Department,Weifang Maternal and Child Health Hospital;Neonatal Department,Weifang Maternal and Child Health Hospital;Department of Pediatrics,Jining First People's Hospital)

机构地区：[1]潍坊市妇幼保健院中心供应室,山东潍坊261011 [2]潍坊市妇幼保健院科教科 [3]潍坊市妇幼保健院儿科 [4]潍坊市妇幼保健院检验科 [5]潍坊市妇幼保健院新生儿科 [6]济宁市第一人民医院儿科

出　　处：《潍坊医学院学报》2021年第1期42-45,共4页Acta Academiae Medicinae Weifang

基　　金：潍坊市卫生计生委科研项目计划(项目编号:2016wsjs044)。

摘　　要：目的分析呼吸窘迫综合征(RDS)极低出生体重(VLBW)和超低出生体重(ELBW)早产儿呼吸机相关性肺炎(VAP)的临床资料。方法选取2017年1月~2019年8月收治的134例RDS超低和极低出生体重早产儿为研究对象,统计VAP发生率,分析VAP的一般影响因素、治疗因素和病原菌特点。结果 134例极低和超低出生体重早产儿中47例(35.1%)发生VAP,87例(64.9%)未发生VAP;胎龄、体重、新生儿危重病例评分(NCIS)≤90分对VAP的发生具有显著性影响(P<0.05);随着机械通气时间的增长和插管次数的增加,感染VAP的患儿显著增加(P<0.05);VAP患儿对冻干静注人免疫球蛋白的使用率更大(P<0.05);革兰氏阴性细菌是VAP的主要致病菌,占79.03%.结论 RDS极低和超低出生体重早产儿VAP发生率较高,患儿出生时的胎龄、体重、NCIS评分≤90分以及呼吸机使用时长对VAP的影响较大。Objective Analysis of clinical data on ventilator-associated pneumonia(VAP) in infants with very low birth weight(VLBW) and ultra-low birth weight(ELBW).Methods From January 2017 to August 2019,134 cases of premature infants with ultra-low and very low birth weight were selected in the neonatal department of Weifang Maternal and Child Health Hospital as the subjects, and the incidence of VAP was calculated, and the general influencing factors, therapeutic factors and pathogenic characteristics of VAP were analyzed.Results Forty-seven cases of very low and ultra-low birth weight preterm birth occurred with VAP with a incidence of 35.1%,and 87 cases did not occur VAP,with a incidence rate of 64.9%;Gestational age, weight, neonatal critical illness score(NCIS)≤90 points had a significant effect on the occurrence of VAP(P<0.05).With the increase of mechanical ventilation time and the number of intubation, the number of children infected with VAP increased significantly(P<0.05);children with VAP were more likely to use freeze-dried static human immunoglobulin(P<0.05),and Gram-negative bacteria were the main pathogenic bacteria of VAP,accounting for 79.03%.Conclusion The incidence of VAP in premature babies with very low and ultra-low birth weight is higher, and the age, weight, NCIS≤90 and the duration of ventilator use have a higher effect on VAP.

关 键 词：肺炎 呼吸机相关性 呼吸窘迫综合征 超低出生体重 极低出生体重 早产 

分 类 号：R722.135[医药卫生—儿科]