摘要
目的:为探讨新生儿重症监护病房(NICU)呼吸机相关性肺炎(VAP)的发病危险因素,制定呼吸机集束(VB)策略预防控制新生儿VAP,降低新生儿VAP的发病率。方法:采用目标性监测,调查NICU VAP的发生率,探讨其危险因素,并应用VB干预策略预防新生儿VAP。采用单中心前后对照研究。将VB干预策略措施实施前1年(对照组)以及实施后3年(干预组)NICU收治的机械通气时间≥48 h的患者纳入该研究。结果:2008年目标性监测发现新生儿VAP日感染率为37.04‰,2009、2010、2011年后实行目标性监测和VB干预策略的预防控制体系,NICU VAP日感染率分别为12.16‰、12.15‰、7.94‰,与2008年日感染率比较差异有统计学意义(P<0.05或P<0.01)。结论:根据NICU VAP感染发生的特点及危险因素,实施目标性监测和VB干预策略的预防控制体系,并进行标准化操作,有效降低了NICU VAP发病率。
Objective： To explore the risk factors of onset of neonatal ventilator-associated pneumonia （VAP） in neonatal inten- sive care unit （ NICU）, make ventilator bundle intervention strategies to prevent and control neonatal VAP, and reduce the incidence rate of neonatal VAP. Methods： Target monitoring method was used to investigate the incidence rate of VAP in NICU and explore the risk factors ; ventilator bundle intervention strategies were applied to prevent neonatal VAP. A monocentric case - control study was performed ; the neo- nates with mechanical ventilation time 〉48 hours from NICU at one year before implementation of ventilator bundle intervention strategies （control group） and at three years alter implementation of ventilator bundle intervention strategies （intervention group） were included into the study. Results： The daily infection rate of neonatal VAP in 2008 was 37.04%0, after implementation of ventilator bundle intervention strategies, the daily infection rates of neonatal VAP in 2009, 2010, and 2011 were 12. 16%e, 12. 15%e, and 7.94%0, respectively, com- pared with the result in 2008, there were statistically significant differences （ P 〈 0. 05 or P 〈 0. 01 ） . Conclusion ： According to the char- acteristics and risk factors of VAP infeetion in NICU, target monitoring method and ventilator bundle intervention strategies can effectively re- duce the incidence rate of VAP in NICU.
出处
《中国妇幼保健》
CAS
北大核心
2013年第34期5720-5722,共3页
Maternal and Child Health Care of China
关键词
目标性监测
呼吸机相关性肺炎
呼吸机集束干预策略
新生儿
Targeted monitoring
Ventilator- associated pneumonia
Ventilator bundle intervention strategy
Neonate
