神经内科ICU呼吸机相关性肺炎监控及干预措施

发布时间：2018-06-29 03:06

本文选题：神经内科ICU + 呼吸机相关性肺炎　；参考：《重庆医科大学学报》2015年01期

【摘要】：目的:探讨神经内科ICU患者发生呼吸机相关性肺炎(ventilator associated pneumonia,VAP)的影响因素及干预措施。方法:对我院2013年1月至2013年12月住院的882例神经内科ICU患者进行调查研究,分析患者VAP的发生率、呼吸机连接方式、病原菌特征、高危影响因素。结果:使用呼吸机176人(有创168人,无创8人),共发生感染42例(有创41例,无创1例),其中有创97.62%,无创2.38%,VAP感染率为23.86%,有创VAP感染率为24.4%,无创VAP感染率为12.5%;感染以革兰阴性菌为主,占85.71%,代表菌属为鲍曼不动杆菌、克雷伯菌、铜绿假单胞菌,其次为革兰阳性菌(9.53%),代表菌属为金黄色葡萄球菌,真菌(4.76%);VAP的高危因素主要有基础性疾病、高龄、住院时间过长、侵袭性操作、滥用抗生素。结论:神经内科ICU是VAP的高发科室,主要以有创呼吸机为主,VAP病原菌以革兰氏阴性菌为主,应积极治疗基础性疾病,严格无菌观念,减少侵袭性操作,合理使用抗菌药,缩短住院时间,预防和控制VAP的发生和发展。
[Abstract]:Objective: To investigate the influencing factors and intervention measures of ventilator associated pneumonia (VAP) in ICU patients in neurology. Methods: 882 cases of Neurology Department of Neurology in our hospital from January 2013 to December 2013 were investigated and studied to analyze the incidence of VAP, the way of ventilator connection, the characteristics of pathogenic bacteria, and the high level of pathogenic bacteria. Results: 176 people (168 people, 8 non invasive) were used, 42 cases were infected (41 cases, 1 non invasive cases), including 97.62%, non invasive 2.38%, VAP infection rate 23.86%, invasive VAP infection rate 24.4%, non invasive VAP infection rate 12.5%, Gram-negative bacteria mainly, accounting for 85.71%, representative of bacteria Bauman Acinetobacter, Klebsiella, Pseudomonas aeruginosa, followed by Gram-positive bacteria (9.53%), the bacteria are Staphylococcus aureus, fungi (4.76%); VAP high risk factors are mainly basic diseases, age, long stay, invasive operation, abuse of antibiotics. Conclusion: the ICU is the high incidence of VAP, mainly with invasive ventilator, VAP disease. The original bacteria are mainly Gram-negative bacteria. They should actively treat basic diseases, strict aseptic concept, reduce invasive operation, use antibiotics reasonably, shorten hospitalization time, prevent and control the occurrence and development of VAP.
【作者单位】：重庆医科大学附属第一医院神经内科;
【基金】：国家临床重点专科建设资助项目(卫办医政函【2012】649号)
【分类号】：R563.1;R741

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