摘要
目的探讨新生儿呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)的危险因素和预防措施。方法对168例机械通气≥48 h的新生儿资料进行回顾性病例对照研究,采用非条件Logistic回归分析进行单因素及多因素分析。结果新生儿VAP发生率为26.8%,41.89/1 000机械通气日;VAP组与对照组患儿死亡率分别为7%和5%,P>0.05,差异无统计学意义;病原菌以革兰氏阴性杆菌为主,占83%;多因素非条件Logistic回归分析的结果显示:机械通气时间≥5 d、出生体质量<2.5 kg、气管内吸引次数≥6次/d是新生儿VAP发生的危险因素。结论新生儿VAP的发生是内部因素与外部因素综合作用的结果,提倡按需适时吸痰,尽量缩短机械通气时间,采取综合措施预防VAP。
Objective To explore the risk factors and nursing strategy of neonatal ventilator-associated pneumonia（VAP）.Methods A retrospective case-control study was conducted on 168 neonates,divided into VAP group and control group,who needed mechanical ventilation for more than 48 hours.Non-conditional Logistic regression analysis was made to determine independent predictors of VAP.Results There were 45 cases of VAP in 168 neonates who were ventilated for more than 48 hours.The incidence was 26.8%,41.89/1 000 ventilator days.The mortality rate was 7% in VAP neonates and that was 5% in control group neonates（P〉0.05）.The main pathogen was G-bacterium（83%）.Multivariate Logistic regression analysis showed that duration of mechanical ventilation,birth weight,endotracheal suction were predicted factors for the development of VAP.Conclusion The development of neonatal VAP was associated with patient’s internal agent and external medical environments.Minimizing endotracheal suction frequency,reducing duration of mechanical ventilation as soon as possible,adopting comprehensive measures were recommended to prevent neonatal VAP.
出处
《护理学报》
2010年第17期4-7,共4页
Journal of Nursing（China）
关键词
新生儿
呼吸机相关性肺炎
危险因素
预防
护理
neonate
ventilator-associated pneumonia
risk factor
prevention
nursing
