摘要
目的分析呼吸机相关性肺炎(VAP)感染的危险因素及相应护理对策。方法采用病例对照研究模式,回顾性分析128例ICU患者临床资料;采用单因素分析法分析VAP发生的相关因素,对差异有显著性因素进一步采用逐步logistic多元回归分析法进行分析,确定VAP发生的独立危险因素。结果 128例患者中,发生VAP41例,发生率32.0%,呼吸机通气时间1～57d;VAP患者中死亡15例,病死率为36.5%;单因素分析结果显示,年龄、连续使用抗菌药物时间、联合用药、插管次数与持续时间、使用糖皮质激素均为VAP发生的相关因素;对差异有显著性因素进行逐步logistic多元回归分析,结果表明,连续使用抗菌药物时间、插管次数与持续时间进入回归方程。结论合理使用抗菌药物、控制和减少呼吸机的使用、科学有效地循证护理可有效降低呼吸机相关性肺炎的发生。
OBJECTIVE To investigate risk factors for ventilator-associated pneumonia （VAP） and propose corresponding nursing measures. METHODS By the means of case-control study mode, the clinical data of 128 ICU patients were retrospectively analyzed; univariate analysis of the related factors for VAP was performed, lo- gistic multivariate regression analysis was performed for further study of the factors with significant difference, the independent risk factors for VAP were determined. RESULTS Of 128 patients, VAP occurred in 41 cases with the incidence of 32.0%, the duration of mechanical ventilation was 1--57 days; the mortality was 36.5% ; the result of univariate analysis indicated that the age, time of continuous use of antibiotics, combined drug treatment, frequency of catheterization, duration of intubation, and use of glucocorticoids were the related factors for VAP （P〈0.05）; multivariate regression analysis showed that the time of continuous use of antibiotics, frequency of intubation, and the duration of intubation were the independent risk factors for VAP. CONCLUSION Reasonable use of antibiotics, control and reduction of use of ventilator, and scientific and effective evidence-based nursing can effectively decrease the incidence of VAP.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第16期3477-3478,3496,共3页
Chinese Journal of Nosocomiology
关键词
呼吸机相关性肺炎
危险因素
护理对策
Ventilator-associated pneumonial Risk factor
Nursing strategy
