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目的探讨ICU呼吸机相关性肺炎(ventilator-associatedpneumonia,VAP)流行病学特征、相关危险因素及对策。方法对新乡市中心医院2007年1月—2009年12月重症监护室内行机械通气患者198例的临床资料进行回顾性分析。结果该组VAP的发生率为37.37%,病死率30.12%。共检出病原菌110株,其中G-杆菌占70.12%,G+球菌占10.31%,真菌占19.57%。非VAP组病死率15%。结论 VAP发病率和病死率高,机械通气时间、高龄、慢性阻塞性肺部疾病、昏迷、使用抑酸剂、留置胃管是VAP的发生的独立危险因素;VAP的主要致病菌为G-杆菌;尽量缩短上机时间和避免医源性危险因素是主要对策。
Objective To investigate the epidemiological characteristics of ventilator-associated pneumonia (VAP) in ICU, the related risk factors and its countermeasures. Methods The clinical data of 198 cases of ICU in ICU from January 2007 to December 2009 in Xinxiang Central Hospital were analyzed retrospectively. Results The incidence of VAP in this group was 37.37% and the case fatality rate was 30.12%. A total of 110 pathogenic bacteria were detected, accounting for 70.12% of G-bacteria, 10.31% of G + bacteria and 19.57% of fungi. Non-VAP group mortality rate of 15%. Conclusion The incidence of VAP and the high mortality rate, mechanical ventilation time, advanced age, chronic obstructive pulmonary disease, coma, use of antacids and indwelling gastric tube are independent risk factors of VAP. The main pathogens of VAP are G- Bacillus; try to shorten the time on the machine and avoid iatrogenic risk factors are the main countermeasures.