摘要
目的探讨机械通气后呼吸机相关性肺炎临床及其病原学特点,以减少发病率,提高治愈率。方法回顾分析35例机械通气后并发呼吸机相关性肺炎患者的临床资料,了解机械通气时间与呼吸机相关性肺炎之间的相关性,检测病原菌及呼吸机相关性肺炎致病菌的药物敏感性,比较气管插管和气管切开后呼吸机相关性肺炎的发病率。结果机械通气时间长的患者易发生呼吸机相关性肺炎,与气管切开相比气管插管易发生呼吸机相关性肺炎;35例患者共检出69株病原菌,其中以革兰阴性细菌为主;35例患者中死亡13例,病死率为37.14%,两种以上病原体感染者较单一致病菌感染者病死率差异有统计学意义(P<0.01)。结论减少机械通气的时间,选择合适的人工气道,应针对病原菌合理选择抗感染药物。
Objective To investigate the clinical and pathogenic feature of VAP（Ventilator-associated pneumonia） after mechanical ventilation then understand its incidence for raising the concern of medical personnel and decreasing morbidity as well as increasing cure rate.Methods the clinical date of 35 cases with VAP in 98 patients with mechanical ventilation was analyzed retrospectively.The correlations between mechanical ventilation time and VAP was concluded.The incidence pathogenic detection and susceptibility for antibiotics of VAP after tracheal intubation were compared with those of VAP after tracheotomy.Results VAP occurred more in patients with longer mechanical ventilation time and tracheal intubation than in patients with shorter mechanical ventilation time and tracheotomy.69 strains which mainly consisted of Gram-negative bacteria were detected in 35 cases.22cases survived and 13 cases died with the mortality of 37.14%.The mortality was even higher in patients who were infected with more than two kinds of pathogens.Conclusion The incidence of VAP could be decreased and the cure rate of VAP could be increased by reducing mechanical ventilation time,choosing right artificial airway and applying antibiotics appropriately.
出处
《安徽医学》
2010年第8期902-904,共3页
Anhui Medical Journal
关键词
呼吸机相关性肺炎
机械通气
病原菌
人工气道
Ventilator-associated pneumonia
Mechanical ventilation
Pathogenic
Artificial airway
