摘要
目的:探讨机械通气后发生呼吸机相关性肺炎(VAP)的临床及病原学特点,为治疗提供依据。方法:观察38例VAP的临床症状;并通过气管分泌物培养及药物敏感试验,分析培养结果的致病微生物及耐药率。结果:38例VAP患者34例细菌检查呈阳性,共检出病原菌株40株,其中革兰阴性菌24株(60%),革兰阳性球菌11株(27.5%),真菌5例(12.5%)。治疗有效26例(68%),无效12例(32%)。结论:病原菌以革兰阴性菌感染为主,呈多重耐药。往往几个因素同时存在,尽早选用有针对性的抗生素,采用降阶梯治疗策略,获得药物敏感试验后,选择敏感抗生素,可收到较好的疗效。
Objective：To explore the clinical and pathogenic features on VAP which is caused after the Mechanical ventilation, to provide the gist for treatment .Methods： observe the clinical symptom on 38 eases of VAP; Through the culture of trachea secretion and antibiotic sensation test ,analysis the culture result of pathogenic microorganism and Drug Resistance Rate.Results：Of totally 38 VAP patients,the culture result of 34 cases was positive. 40 strains of pathogenic bacteria were detected.Among these, 24 strains（60% ） were Gram positive while 11 strains（27.5% ） were Gram negative, and 5 strains（ 12.5% ） belonged to epiphyte. After treatment, 26 cases（68% ） were effective whereas 12 cases（32% ） were not effective. Conclusion： Most pathogenic bacteria were Gram negative and of multiple drug resistance. VAP are always resulted by several factors, and the relation among these factors are complicated. Integrated prevention steps were advised to take for the treatment of VAP, and specific antibiotic should be used as soon as possible. De - escalation therapy strategy was applied in the treatment of VAP. Choosing the sensitive antibiotic after antibiotic sensation test, the effect of the treatment is qu/te satisfacting.
出处
《现代医药卫生》
2005年第16期2111-2112,共2页
Journal of Modern Medicine & Health
关键词
机械通气
肺炎
病原微生物
Mechanical ventilation
Pneumonia
Pathogenic microorganism
