综合医院呼吸机相关性肺炎发生情况及相关因素分析  

Analysis on the incidence and related factors of ventilator-related pneumonia in a general hospital

作　　者：刘玉岭[1] 夏宏林[1] 张会平[2] 刘杰[1] 郝维敏[1] LIU Yu-ling;XIA Hong-lin;ZHANG Hui-ping;LIU Jie;HAO Wei-min(Department of Clinical Center Laboratory,Suzhou Hospital of Anhui Medical University,Suzhou,Anhui 234000,China;不详)

机构地区：[1]安徽医科大学附属宿州医院临床中心实验室,安徽宿州234000 [2]安徽医科大学附属宿州医院医院感染管理科

出　　处：《中华全科医学》2022年第4期685-687,共3页Chinese Journal of General Practice

基　　金：安徽省重点研究与开发计划项目(202004j07020026);宿州市科技计划项目(SZSKJJZC031)。

摘　　要：目的探讨重症监护病房(ICU)呼吸机相关性肺炎(VAP)发生情况和相关因素,为综合医院制定切实可行的VAP感染防控策略提供依据。方法2017—2018年在某综合医院ICU(包括ICU、EICU和NICU)开展VAP目标性监测,对使用呼吸机和发生VAP的患者进行调查,分析VAP发生情况、相关因素和病原菌特点。使用SPSS 20.0统计学软件进行数据分析,应用单因素分析和多因素logistic回归模型分析VAP发生的相关因素。结果(1)2017—2018年ICU患者的呼吸机使用率为33.58%,共发生VAP感染58例次,感染率为5.89‰。2018年ICU患者呼吸机使用率较2017年低,差异有统计学意义(P<0.05)。(2)年龄(P<0.001)、脑出血(P=0.028)、气管切开(P=0.009)、患者住院天数(P<0.001)和呼吸机使用天数(P<0.001)是VAP的危险因素,差异有统计学意义。年龄、气管切开和患者使用呼吸机天数与VAP的发生密切相关(OR>1,P<0.05)。(3)VAP相关病原菌培养居于前列的分别为:鲍曼不动杆菌(27株,58.62%)、肺炎克雷伯菌(17株,24.14%)、奇异变形杆菌(4株,6.90%)和铜绿假单胞菌(4株,6.90%)。结论综合医院应加强VAP监测和防控,关注危险因素,降低VAP发生率。Objective To investigate the incidence and related factors of ventilator associated pneumonia(VAP)in the intensive care unit(ICU)of a general hospital,and guide the prevention and control of VAP.Methods Target monitoring of VAP was carried out in the ICU of a general hospital(including ICU,EICU and NICU)from 2017 to 2018.Patients on ventilator and patients with VAP were investigated.The occurrence of VAP,related factors and pathogen characteristics were analysed.SPSS 20.0 software was used to establish a multivariate logistic regression model and analyse the related factors of VAP.Results(1)The utilisation rate of ventilators in ICU patients was 33.58%,a total of 58 cases of VAP infection occurred,and the infection rate of VAP was 5.89‰.The use rate of ventilators in ICU patients in 2018 was lower than that in 2017,and the difference was statistically significant(P<0.05).(2)Age(P<0.001),cerebral haemorrhage(P=0.028),tracheotomy(P=0.009),length of stay in the hospital(P<0.001)and length of ventilator use(P<0.001)were risk factors for VAP,whilst age,tracheotomy and length of ventilator use were independent risk factors for VAP(OR>1,P<0.05).(3)The top VAP-related pathogens were Acinetobacter baumannii(27,58.62%),Klebsiella pneumoniae(17,24.14%),Proteus mirabilis(4,6.90%)and Pseudomonas aeruginosa(4,6.90%).Conclusion The monitoring and prevention of VAP should be strengthened,and the risk factors should be focused to reduce the incidence of VAP.

关 键 词：呼吸机相关性肺炎 危险因素 防控 

分 类 号：R563.1[医药卫生—呼吸系统]