重症监护室机械通气患者发生呼吸机相关肺炎的危险因素分析及护理策略  

Analysis on Risk Factors and Nursing Strategies of Ventilator-Associated Pneumonia in ICU Patients with Mechanical Ventilation

作　　者：赵梓 王溪萍 ZHAO Zi;WANG Xiping(ICU,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473003,China)

机构地区：[1]南阳医学高等专科学校第一附属医院重症医学科,河南南阳473003

出　　处：《临床医学工程》2023年第1期137-138,共2页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(2018410257)。

摘　　要：目的探讨重症监护室(ICU)机械通气患者发生呼吸机相关肺炎(VAP)的危险因素及护理策略。方法选取86例ICU机械通气患者,根据是否合并VAP分为VAP组(n=41)和非VAP组(n=45)。比较两组的临床特征,采用Logistic回归分析ICU机械通气患者发生VAP的影响因素。结果VAP组机械通气时间≥10 d、意识障碍、留置胃管、未预防性应用抗生素占比均高于非VAP组(P<0.05)。Logistic回归分析显示,VAP组机械通气时间≥10 d、意识障碍、留置胃管是ICU机械通气患者发生VAP的独立危险因素(OR>1,P<0.05),而预防性应用抗生素是ICU机械通气患者发生VAP的保护因素(OR<1,P<0.05)。结论ICU机械通气患者发生VAP的影响因素较多,临床应针对危险因素制定相应干预措施,以降低VAP发生风险。Objective To explore the risk factors and nursing strategies of ventilator-associated pneumonia(VAP)in ICU patients with mechanical ventilation.Methods 86 ICU patients with mechanical ventilation were divided into VAP group(n=41)and non VAP group(n=45)according to VAP or none.The clinical characteristics of the two groups were compared,and the influencing factors of VAP in ICU patients with mechanical ventilation were analyzed by Logistic regression.Results The proportion of mechanical ventilation time≥10 days,consciousness disorder,gastric tube indwelling,and non preventive use of antibiotics in VAP group were higher than those in non VAP group(P<0.05).Logistic regression analysis showed that the mechanical ventilation time≥10 days,consciousness disorder and gastric tube indwelling were independent risk factors for VAP in ICU patients with mechanical ventilation(OR>1,P<0.05),and preventive use of antibiotics was protective factor for VAP in ICU patients with mechanical ventilation(OR<1,P<0.05).Conclusions Many factors affect the VAP occurrence in ICU patients with mechanical ventilation,and clinical intervention measures should be formulated according to the risk factors to reduce the VAP risk.

关 键 词：重症监护室 呼吸机相关肺炎 危险因素 机械通气 

分 类 号：R473.5[医药卫生—护理学]