呼吸机管路内细菌污染与呼吸机相关性肺炎的相关性研究

发布时间：2018-03-06 14:18

本文选题：呼吸机相关性肺炎　切入点：细菌污染　出处：《中华医院感染学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨呼吸机管路内细菌与下呼吸道感染时间的相关性,为预防呼吸机相关性肺炎(VAP)提供依据。方法选取2015年6月-2016年6月入住综合ICU行机械通气的Ⅱ型呼吸衰竭患者122例,于上机后在不同时间段采集下呼吸道分泌物、呼吸机湿化罐、进气口及出气口冷凝水集水杯、螺纹管呼气接口内壁标本进行细菌培养,观察不同部位细菌生长情况,记录机械通气时间、ICU住院时间、呼吸机相关性肺炎发生率等。结果 122例机械通气患者,共收集培养标本1 898份,呼吸机湿化罐、进气口及出气口冷凝水集水杯、螺纹管呼气接口内壁细菌生长率与机械通气时间呈正相关(r=0.8545,0.9636,0.9636,0.9394;P0.05);出气口冷凝水集水杯细菌出现最早,呼吸机湿化罐细菌出现最晚;各部位与下呼吸道分泌物细菌培养均以革兰阴性菌为主;全部患者中发生VAP19例,VAP发生率15.57%,随着机械通气时间的延长,VAP发生率逐渐增加,机械通气时间5d与7d分组比较,VAP发生率差异有统计学意义(P0.05);19例VAP患者中,出气口冷凝水集水杯、螺纹管呼气端接口端内壁、进气口冷凝水集水杯及呼吸机湿化罐与下呼吸道分泌物细菌培养一致性分别为66.48%、63.45%、40.26%及54.32%,进气口冷凝水集水杯及呼吸机湿化罐的细菌出现时间与下呼吸道病原菌的出现时间基本一致。结论呼吸机管路细菌污染状况及VAP的发生与机械通气时间均存在相关性,呼吸机管路细菌污染可能是造成VAP发生的原因之一,建议定期更换呼吸机管路。
[Abstract]:Objective to investigate the correlation between bacteria in ventilator and time of lower respiratory tract infection, for the prevention of ventilator-associated pneumonia (VAP) provides the basis for the 122 patients with type II respiratory failure. Methods from June 2015 June -2016 year in comprehensive ICU of mechanical ventilation in the upper respiratory tract were collected at different times after lower secretion, airway humidification, air inlet and the air outlet of the condensed water collecting cup, threaded pipe inner wall interface expiratory specimens for bacterial culture, bacterial growth was observed in different parts of the record, the mechanical ventilation time, ICU stay, the incidence of ventilator-associated pneumonia. Results 122 cases of patients with mechanical ventilation were collected, 1898 specimens were cultured, airway humidification, air inlet and outlet in the condensed water collecting cup, threaded pipe inner wall interface expiratory bacterial growth was positively correlated with the duration of mechanical ventilation (r= 0.8545,0.9636,0.9636,0.9394; P0.05); a Air condensate water bacteria appeared, airway humidification bacteria appears late; parts and secretion of lower respiratory tract bacterial culture were Gram-negative bacteria; VAP19 cases occurred in all patients, the incidence rate of VAP was 15.57%, with prolonged mechanical ventilation, the incidence of VAP increased gradually, compared with mechanical ventilation 5D and 7d group, there was significant difference in incidence of VAP (P0.05); 19 patients with VAP, the outlet of condensed water in the cup, threaded pipe end expiratory end wall interface, the condensed water inlet water and airway humidification and lower respiratory tract secretions bacterial culture consistency were 66.48%, 63.45%. 40.26% and 54.32%, and the condensed water inlet water airway humidification bacteria time and lower respiratory tract pathogens appeared almost at the same time. Conclusion the ventilator of bacterial contamination and the occurrence of VAP and mechanical ventilation There is a correlation between all of them. Bacterial contamination in ventilator pipeline may be one of the reasons for the occurrence of VAP. It is suggested that the ventilator pipeline should be replaced regularly.

【作者单位】：河北医科大学附属华北石油管理局总医院医院感染管理科;
【分类号】：R563.1

【相似文献】