摘要
目的探讨综合重症监护病房（ICU）机械通气并发肺部感染的独立危险因素。方法对我院2006年10月至2008年6月入住综合ICU行有创机械通气的患者80例进行前瞻性队列研究，根据是否发生肺部感染，先用单因素分析筛选有统计学意义的危险因素，再通过多元Logistic回归分析，确定机械通气并发肺部感染的独立危险因素。结果本组患者肺部感染发生率为47．50％。单因素分析提示年龄、低蛋白血症、慢性阻塞性肺疾病（COPD）史、机械通气时间、多种抗生素的应用、ICU住院天数是肺部感染的危险因素，回归分析提示机械通气时间和多种抗生素的应用的相对危险度及其95％可信区间分别为1．257（1．004～3．587）、P=0．024，6．243（4．013—39．525）、P=0．007。结论肺部感染的发生与多种临床因素相关，机械通气时间和多种抗生素的应用是肺部感染的独立危险因素。
Objective To explore independent risk factors of ventilator- associated hospital acquired pulmonary infection in comprehensive ICU. Methods A prospective cohort study was made on patients with mechanical ventilation were hospitalized from October 2006 to June 2008. Several statistically significant risk factors were screened out with univariate analysis, then independent risk factors were determined with multivariate stepwise logistic regression analysis. Results The morbidity of ventilator - associated hospital acquired pulmonary infection was 47.50% in this groups. Univariate analysis showed that age, hypoalbuminemia, history of chronic obstructive pulmonary emphysema, the duration of mechanical ventilation, the use of various antibiotics and the length of stay in ICU were statistically significant risk factors of pulmonary infection. While multivariate stepwise logistic regression analysis showed that the relative risk and 95% confident interval of the duration of mechanical ventilation, the use of various antibiotics were respectively 1. 257 （ 1. 004 - 3. 587 ）, P = 0. 024 ; 6. 243 （4. 013 - 39. 525 ）, P ： 0. 007. Conclusions The occurrence of ventilator - associated hospital acquired pulmonary infection is related to multiple clinical factors. The duration of mechanical ventilation and the use of various antibiotics are independent and significant risk factors of ventilator - associated hospital acquired pulmonary infection.
出处
《中国实用医刊》
2009年第11期31-33,共3页
Chinese Journal of Practical Medicine
