摘要
目的分析呼吸机相关性肺炎(VAP)的发生率及危险因素,探讨护理预防对策。方法回顾性分析176例机械通气患者临床资料,观察VAP与年龄、营养不良状态、使用制酸剂及抗菌药物、胃内容物反流、机械通气时间、不良心理反应等变量的相关性;应用SPSS13.0软件进行单因素条件logistic回归分析。结果 176例机械通气治疗患者发生VAP42例,发生率为23.86%;logistic回归分析结果显示,引起VAP的危险因素包括:高龄(OR=3.12)、胃内容物反流(OR=4.02)、血清白蛋白低(OR=3.08)、机械通气时间长(OR=4.16)、抗酸剂应用(OR=2.67)、预防应用抗菌药物(OR=2.69)、存在不良心理反应(OR=2.87);VAP组呼吸机依赖发生率、住院时间、病死率分别为23.81%、(34.23±10.34)d、14.29%,非VAP组分别为11.19%、(17.28±4.34)d、2.23%,两组比较差异有统计学意义(P<0.05)。结论 VAP发生率较高,影响因素复杂,对预后有不良影响,应加强对高危因素的预防护理,以减少和预防VAP的发生。
OBJECTIVE To analyze the incidence of ventilator-associated pneumonia （VAP）, observe the risk factors, and put forward nursing countermeasures. METHODS The clinical data of 176 patients who underwent mechanical ventilation were retrospectively analyzed, then the correlation between the VAP and the variables, including the age, malnutrition, use of antacids or antibiotics, reflux of gastric contents, duration of mechanical ventilation, and adverse psychological reactions were observed, and the conditional univariate logistic regression analysis was performed with the use of SPSSI3.0 software. RESULTS Of the 176 patients who underwent the mechanical ventilation, the VAP occurred in 42 cases with the incidence rate of 23.86 %. The results of the logistic regression analysis indicated that the risk factors for VAP included the advanced age （OR=3.12）, reflux of gastric content （OR=4.02）, hypoalbuminemia （OR=3.08）, prolonged mechanical ventilation （OR=4.16）, use of antacids （OR= 2.67）, use of prophylactic antibiotics （OR= 2.69）, and adverse psychological reactions （OR= 2.87）. The utilization rate of ventilator was 23.81% in the VAP group, 11.9 % in the non-VAP group; the hospitalization duration was （34. 234-10.34） days in the VAP group, （17. 28±4.34）days in the non-VAP group; the mortality rate was 14.29% in the VAP group, 2.23% in the non-VAP group; the differences between the two groups were significant （P〈0.05）. CONCLUSION The incidence of VAP is high, and the risk factors are complicated, which has adverse effect on the prognosis. It is necessary to strengthen the nursing prevention of the high-risk factors so as to reduce the incidence of VAP.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第17期4240-4242,共3页
Chinese Journal of Nosocomiology
基金
广东省科技局基金资助项目(2012A061400010)
关键词
呼吸机相关性肺炎
影响因素
护理对策
Ventilator-associated pneumonia
Influencing factor Nursing countermeasure
