无创机械通气患者医院获得性肺炎相关危险因素分析

发布时间：2018-07-27 17:27

【摘要】：目的:探讨无创机械通气患者发生医院获得性肺炎(hospital acquired pneumonia,HAP)的相关危险因素,从而为临床实施干预提供参考依据。方法:回顾性分析某三甲医院2014年12月至2016年2月呼吸内科重症监护室440例无创机械通气患者的临床资料,采用logistic回归分析发生HAP的高危因素。结果:440例无创机械通气患者中发生HAP15例,感染发生率为3.41%;单因素分析结果显示,合并糖尿病、APACHEⅡ评分18分、ICU住院天数10 d、无创机械通气时间7 d、血清白蛋白水平低于25 g/L、留置胃管、呼吸机管路使用时间7 d以及人工吸痰都与无创机械通气患者发生HAP具有相关性(P0.05);多因素分析结果显示,APACHEⅡ评分18分(OR=4.665,95%CI=1.2~18.134,P=0.026)、ICU住院天数10 d(OR=11.261,95%CI=2.234~56.757,P=0.003)以及人工吸痰(OR=12.561,95%CI=2.846~55.441,P=0.000)是无创机械通气患者发生HAP的独立危险因素。结论:病情危重、ICU住院时间较长(10 d)以及患者自主排痰能力较差需人工吸痰的无创机械通气患者发生HAP的感染率较高,如果患者存在以上危险因素,应加强对HAP的预防。
[Abstract]:Objective: to investigate the risk factors of nosocomial pneumonia (hospital acquired) in patients with non-invasive mechanical ventilation. Methods: the clinical data of 440 patients with non-invasive mechanical ventilation in intensive care unit of respiratory department from December 2014 to February 2016 were analyzed retrospectively. Logistic regression analysis was used to analyze the risk factors of HAP. Results among the 440 cases of non-invasive mechanical ventilation, HAP15 was found in 10 cases, the incidence of infection was 3.41%, and the results of univariate analysis showed that, Patients with diabetes mellitus had 18 scores of Apache 鈪，

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