呼吸机相关肺炎发病率及危险因素前瞻性研究

发布时间：2018-02-27 04:36

  本文关键词： 呼吸机相关肺炎 危险因素 发病率 医院感染 病例对照 前瞻性研究　出处：《中国感染控制杂志》2016年11期 　论文类型：期刊论文

【摘要】：目的了解呼吸机相关肺炎(VAP)发病率及其危险因素,为预防VAP提供依据。方法对2006年1月—2011年12月2所三级甲等综合医院使用呼吸机患者开展VAP前瞻性监测,选取发生VAP医院感染患者作为VAP组,未发生VAP医院感染患者作为非VAP组(1∶1配比),进行危险因素分析。结果共监测使用呼吸机患者2 550例,发生VAP475例,机械通气总日数32 623 d,VAP发病率为14.56‰。单因素分析表明:反复呼吸道感染病史、1个月内使用广谱抗菌药物、多次住院、昏迷、低蛋白血症、脱机失败后再次插管、使用糖皮质激素、机械通气5 d、误吸、口腔卫生情况差是VAP发生的危险因素。多因素logistic回归分析显示,昏迷(OR95%CI:1.38~2.93)、低蛋白血症(OR95%CI:1.12~2.10)、使用糖皮质激素(OR95%CI:1.10~2.24)、脱机失败再次插管(OR95%CI:2.14~4.74)、机械通气5 d(OR95%CI:2.55~4.83)、误吸(OR95%CI:1.24~2.77)、口腔卫生情况差(OR95%CI:1.72~3.74)是VAP发生的独立危险因素。结论 VAP发病率较高,其危险因素众多,应采取正确的口腔清洁、抬高头位、及时评估撤机、改善营养状况等综合干预措施,降低VAP的发病率。
[Abstract]:Objective to investigate the incidence and risk factors of ventilator-associated pneumonia (VAP) and to provide evidence for the prevention of VAP. Methods VAP prospective monitoring was carried out on patients with ventilator in Grade 3A General Hospital from January 2006 to December 2nd 2011. Patients with nosocomial infection of VAP were selected as VAP group, patients with nosocomial infection of VAP were selected as proportion of 1: 1 in non-#en3# group, and the risk factors were analyzed. Results A total of 2 550 patients with ventilator were monitored and VAP475 cases were detected. The total number of days of mechanical ventilation was 32 623 days and the incidence of VAP was 14.56 鈥，

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