呼吸机相关性肺炎：从指南到实践被引量：31

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摘要目前,根据呼吸机相关性肺炎（VAP）定义和患者人群不同,VAP在全球范围内的发病率为6%~52%或（1.6~52.7）例/1 000机械通气日,病死率为14%~50%.VAP导致重症医学科（ICU）留治时间延长、住院费用增加,且是危重症患者重要的致死原因.近十年来,美国、英国、加拿大等国家相继出台了VAP相关的诊疗指南[1-4],VAP防治取得了长足进步,发病率不断下降,在美国甚至有呼声将VAP纳入政府医疗保险机构拒绝支付目录.而我国VAP的高发病率和高死亡率形势仍旧严峻,如何遏制VAP已成为临床医学领域亟待解决的重大课题.近日,中华医学会重症分会发布了〈呼吸机相关性肺炎预防、诊断和治疗指南（2013）＆gt;[5]（以下均简称〈VAP指南＆gt;）.其借鉴了国内外主要学术组织如美国重症医学会及胸科协会、英国抗微生物及化学治疗协会等制定指南的经验,基于临床常见及热点问题,结合近年来的研究进展,应用循证医学的方法,重点对呼吸机相关性肺炎的预防、诊断和治疗方面进行了详细的介绍.

作者黎毅敏

机构地区广州医科大学附属第一医院广州呼吸疾病研究所重症医学科广州呼吸疾病国家重点实验室

出处《中华医学杂志》 CAS CSCD 北大核心 2014年第5期321-323,共3页 National Medical Journal of China

关键词呼吸机相关性肺炎诊疗指南危重症患者中华医学会重症医学高发病率医疗保险机构 VAP

分类号 R563.1 [医药卫生—呼吸系统]

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