论文部分内容阅读
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 neonatal ventilator-associated pneumonia (VAP) in neonatal intensive care unit (NICU) and develop a ventilator cluster (VB) strategy to prevent and control neonatal VAP and reduce the incidence of neonatal VAP. Methods: With targeted surveillance, the incidence of NICU VAP was investigated to explore the risk factors and VB intervention strategy was used to prevent neonatal VAP. Single-center control study before and after. Patients in the NICU admitted to NICU for 1 year (control group) and ≥48 h after 3-year intervention (intervention group) were enrolled in this study. Results: In 2008, the target surveillance showed that the neonatal VAP infection rate was 37.04 ‰. After 2009, 2010, and 2011, the targeted prevention and control system with targeted surveillance and VB intervention strategy was adopted. The prevalence of VAP on NICU was 12.16 ‰ and 12.15 ‰, respectively , 7.94 ‰, respectively. The difference was statistically significant compared with that of 2008 (P <0.05 or P <0.01). Conclusion: According to the characteristics and risk factors of NICU VAP infection, the preventive and control system of target monitoring and VB intervention strategy was implemented and standardized. The incidence of VAP in NICU was effectively reduced.