新生儿呼吸机相关性肺炎的高危因素及风险护理流程策略  

High-risk factors and risk nursing process strategies of ventilator-associated pneumonia in neonates

作　　者：张小茹 胡小英 Zhang Xiaoru;Hu Xiaoying(Department of Neonatology,the First Afiliated Hospital of Xiamen University,Xiamen 361000,China)

机构地区：[1]厦门大学附属第一医院新生儿科,厦门361000

出　　处：《国际护理学杂志》2024年第20期3808-3812,共5页international journal of nursing

摘　　要：目的分析新生儿呼吸机相关性肺炎(Ventilator-Associated Pneumonia,VAP)的高危因素及风险护理流程策略。方法回顾性分析2021年1月至2023年1月于厦门大学附属第一医院新生儿科行机械通气辅助治疗的105例新生儿资料,根据是否发生VAP分为VAP组34例和非VAP组71例。比较两组患儿基础及临床资料,并分析新生儿发生VAP的危险因素以制定针对性护理流程策略。结果VAP组患儿28周≤出生胎龄<37周、出生体质量<2500 g、营养状况小于胎龄、预防性应用抗生素、再插管、机械通气时间>5 d占比均高于非VAP组,差异均有统计学意义(均P<0.05);Logistic回归分析显示,28周≤出生胎龄<37周、出生体质量<2500 g、再插管、预防性应用抗生素、机械通气时间>5 d均为新生儿发生VAP的独立风险因素(均P<0.05)。结论28周≤出生胎龄<37周、出生体质量<2500 g、预防性应用抗生素、再插管、机械通气时间>5 d为新生儿VAP的高危因素,临床可针对上述风险因素进行针对性的护理干预,以降低行机械通气辅助治疗的新生儿发生VAP的风险。ObjectiveTo analyze the high-risk factors and risk nursing process strategies of ventilator-associated pneumonia(VAP)in neonates.MethodsA retrospective analysis was performed on the data of 105 neonates who were treated with mechanical ventilation in the department of neonatology of the First Affiliated Hospital of Xiamen University from January 2021 to January 2023.According to the occurrence of VAP,they were divided into the VAP group(34 cases)and the non-VAP group(71 cases).The basic and clinical data of the two groups were compared,and the risk factors of neonatal VAP were analyzed to formulate the targeted nursing process strategy.ResultsCompared with the non-VAP group,the VAP group had significantly higher proportions of infants with gestational age greater than or equal to 28 weeks and less than 37 weeks,birth weight less than 2500 g,nutritional status smaller than gestational age,prophylactic use of antibiotics,reintubation,and mechanical ventilation longer than 5 days,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that gestational age at birth greater than or equal to 28 weeks and less than 37 weeks,birth weight less than 2500 g,reintubation,prophylactic use of antibiotics and mechanical ventilation longer than 5 days were independent risk factors for VAP in neonates(P<0.05).ConclusionsGestational age of birth greater than or equal to 28 weeks and less than 37 weeks,birth weight less than 2500 g,prophylactic use of antibiotics,reintubation,mechanical ventilation time more than 5 days are the high risk factors of VAP in neonates.Clinical nursing intervention can be carried out according to the above risk factors to reduce the risk of VAP in neonates with mechanical ventilation.

关 键 词：新生儿 机械通气 呼吸机相关性肺炎 风险护理 

分 类 号：R473.72[医药卫生—护理学]