摘要
目的探讨呼吸机相关性肺炎(VAP)临床特征及预防对策。方法回顾性分析280例机械通气治疗患者的临床资料,观察VAP发生率、病原学检查结果、影响VAP相关因素、VAP对预后的影响。结果 280例患者合并VAP90例,发生率32.14%;90例患者培养出病原菌130株,其中革兰阴性杆菌80株,占61.54%,革兰阳性球菌30株,占23.08%,真菌20株,占15.38%;引起VAP的危险因素包括:胃内容物反流、呼吸机应用时间长、平卧位置、APACHEⅡ评分高;发生VAP患者的死亡率为18.89%,高于未发生VAP的4.21%(P<0.05)。结论 VAP发生率较高,应采取有效的预防措施,降低VAP的发生;对于VAP治疗抗菌药物采用降阶梯治疗措施。
OBJECTIVE To explore the clinical features of ventilator associated pneumonia （VAP） and the preventive countermeasures. METHODS The clinical data of 280 patients who underwent mechanical ventilation were retrospectively analyzed. The incidence of VAP, the result of etiology inspection, and related factors for VAP, and the influence of VAP on prognosis were observed. RESULTS VAP occurred in 90 of 280 patients with the incidence of 32.14% totally I30 strains of pathogens were cultured from 90 patients, including 80 （61.54 %） strains of gram-negative bacilli, 30 （23.08%） strains of gram-positive cocci, and 20 （15.38%） strains of fungi. The risk factors for VAP included the reverse flow of stomach contents, long time use of ventilator, supine location, and high APACHE lI score. The mortality of the patients with VAP was 18.89 %, higher than 4.21 of the patients without VAP （P〈0.05）. CONCLUSION The incidence of VAP is high. It is necessary to take effective preventive measures to reduce the incidence of VAP De-escalation use of antibiotics should be adopted for the treatment of VAP.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第7期1358-1359,共2页
Chinese Journal of Nosocomiology
关键词
呼吸机相关性肺炎
临床特点
预防对策
Ventilator-associated pneumonia Clinical characteristics Preventive countermeasures
