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目的探讨新生儿呼吸机相关性肺炎(VAP)的治疗与预防方法。方法 66例(其中男41例,女25例)因呼吸衰竭上呼吸机时间大于48 h 的患儿均采用半卧位,经气管插管或气管切开导管吸痰。标本送实验室作革兰氏染色和细菌培养,同时作药敏试验。结果 66例患儿中17例发生 VAP,占25.8%。4例为多菌种混合感染,占23.5%。在17例 VAP 中治愈lO例,自动出院5例,死亡2例(包括肺出血1例,MODS 1例)。分离出病原菌25株,其中革兰氏阴性杆菌21株(84%),依次为大肠埃希氏菌、肺炎克雷白杆菌、阴沟肠杆菌等。结论新生儿呼吸机相关性肺炎主要病原菌为大肠埃希氏菌、肺炎克雷白杆菌、阴沟肠杆菌、不动杆菌等革兰氏阴性杆菌。
Objective To investigate the treatment and prevention of neonatal ventilator-associated pneumonia (VAP). Methods Sixty-six cases (41 males and 25 females) were treated with semi-recumbent endotracheal intubation or endotracheal intubation for suctioning sputum. Specimens sent to the laboratory for Gram stain and bacterial culture, while susceptibility testing. Results VAP occurred in 17 of 66 children (25.8%). 4 cases of multi-strain mixed infection, accounting for 23.5%. In 17 cases of VAP lO cases were cured, 5 cases were discharged automatically, 2 patients died (including 1 case of pulmonary hemorrhage, 1 case of MODS). Twenty-five pathogenic bacteria were isolated, of which 21 (84%) were Gram-negative bacilli, followed by Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae. Conclusion The main pathogens of neonatal ventilator-associated pneumonia are Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter and other Gram-negative bacilli.