慢性阻塞性肺疾病无创机械通气患者痰培养分析

发布时间：2018-03-22 23:36

本文选题：无创机械通气　切入点：慢性阻塞性肺疾病　出处：《中华医院感染学杂志》2014年21期 　论文类型：期刊论文

【摘要】：目的了解慢性阻塞性肺疾病(COPD)无创机械通气患者感染细菌的分布及耐药性,为临床治疗护理提供依据。方法回顾性调查2011年6月-2012年6月60例应用无创机械通气的COPD患者痰培养结果,采用法国生物梅里埃公司VITEK-2Compact全自动微生物分析仪进行细菌鉴定和药敏试验,采用SPSS13.0软件对各数据进行统计分析。结果 60例COPD无创机械通气患者痰培养阳性40例,阳性率66.7%,检出病原菌以革兰阴性菌为主,主要为肺炎克雷伯菌、铜绿假单胞菌、鲍氏不动杆菌,分别占37.5%、17.5%、12.5%,且对多种抗菌药物耐药,肺炎克雷伯菌、铜绿假单胞菌及鲍氏不动杆菌对抗菌药物的耐药率分别为为0~60.0%、0~28.0%、20.0%~100.0%。结论 COPD无创机械通气患者应采取综合防治措施,加强呼吸机管路及呼吸道的护理管理,实施有效的消毒隔离措施,严格执行无菌操作技术,加强对病原菌的监测,合理应用抗菌药物,以提高临床疗效。
[Abstract]:Objective to investigate the distribution and drug resistance of bacterial infection in patients with chronic obstructive pulmonary disease (COPD) undergoing noninvasive mechanical ventilation. Methods from June 2011 to June 2012, the sputum culture results of 60 patients with COPD undergoing non-invasive mechanical ventilation were retrospectively investigated. The bacterial identification and drug sensitivity test were carried out by VITEK-2Compact automatic microbiological analyzer of French Bio-Meridier Company. The data were statistically analyzed by SPSS13.0 software. Results 40 cases of sputum culture were positive in 60 cases of COPD non-invasive mechanical ventilation, 40 cases were positive for sputum culture, and 40 cases were positive for sputum culture. The positive rate was 66.7%. The main pathogenic bacteria were Gram-negative bacteria, mainly Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, which accounted for 37.5% and 17.5% respectively, and were resistant to various antibiotics and Klebsiella pneumoniae. The drug resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to antimicrobial agents were 0 ~ (60.060) and 0.28.00.0.0.Conclusion Comprehensive preventive and therapeutic measures should be taken in patients with non-invasive mechanical ventilation of COPD, and nursing management of ventilator and respiratory tract should be strengthened. In order to improve the clinical efficacy, effective disinfection and isolation measures, strict implementation of aseptic operation techniques, strengthening the monitoring of pathogenic bacteria and rational application of antimicrobial agents were carried out.
【作者单位】：绍兴市人民医院呼吸内科;
【基金】：绍兴市科技基金资助项目(2008A23005)
【分类号】：R563.9

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