呼吸机相关肺炎在多中心不同场所ICU的危险因素研究

发布时间：2018-06-08 21:27

  本文选题：重症监护病房 + 呼吸机相关肺炎　； 参考：《中华医院感染学杂志》2017年13期

【摘要】：目的了解重症监护病房(ICU)呼吸机相关肺炎(VAP)的发病率及相关危险因素,为临床制定预防VAP防控措施提供依据。方法采用统一设计、多中心合作的方法,对部队19所三级甲等综合医院6个类型27个ICU开展前瞻性监测,监测对象为2015年6月-2016年5月所有入住ICU并插管使用呼吸机的患者。结果共监测患者3488例,发生VAP393例,发病率为11.27%;住院总日数为128572d,插管总日数40114d,VAP千日感染率为9.80‰,呼吸机使用率为31.20%;不同类型ICU VAP发病率为4.91%~26.95%,千日感染率为5.74‰~34.79‰;病死率为25.45%,治愈率为2.80%;单因素结果显示,VAP相关危险因素与年龄、住ICU天数、基础疾病数量、机械通气时间、置管次数和口腔清洁次数有关(P0.05);多因素logistic回归分析结果显示,住ICU天数、机械通气时间、置管次数是VAP发生的独立危险因素;共检出446株病原菌,其中革兰阴性菌占89.01%,革兰阳性菌占7.17%,真菌占3.81%。结论通过开展"医院感染预防与控制能力建设"项目,明确发生VAP的相关危险因素,有针对性地制定防控措施和规范操作流程。
[Abstract]:Objective to investigate the incidence and risk factors of ventilator associated pneumonia (VAP) in intensive care unit (ICU) and to provide evidence for clinical prevention and control of VAP. Methods A unified design and multi-center cooperative method was used to carry out prospective monitoring of 27 ICUs of 6 types in 19 Grade 3A General Hospitals in our army. The monitoring subjects were all patients admitted to Grade 3A from June 2015 to May 2016 and intubated with ventilator. Results 3488 patients were monitored, and the incidence of VAP was 11.27.The total number of days in hospital was 128572 days, the total number of days of intubation was 40114 days, the infection rate of VAP was 9.80 鈥，

本文编号：1997195