早发型与迟发型呼吸机相关性肺炎的对比分析
发布时间：2018-09-06 12:21
【摘要】：目的分析迟发型呼吸机相关性肺炎(VAP)的临床特点及病原菌的分布,并与早发型VAP作一比较,为临床经验性用药提供参考依据。方法选取2010年3月-2012年11月103例VAP患者,按照发生VAP的时间不同分为早发型及迟发型,比较两者在临床特征、病原学及预后的差异;采用SPSS17.0软件进行分析,计量资料以均数±标准差表示,组间计量资料比较采用t检验,计数资料采用χ2检验。结果早发型VAP组79例患者痰培养阳性58例,阳性率为73.4%,分离出病原菌73株,以鲍氏不动杆菌、洋葱伯克霍尔德菌、MRSA、肺炎克雷伯菌为主,分别占16.4%、15.1%、15.1%、13.7%;迟发型VAP组24例患者痰培养阳性20例,阳性率为83.3%,分离出病原菌33株,以鲍氏不动杆菌、洋葱伯克霍尔德菌、肺炎克雷伯菌、铜绿假单胞菌为主,分别占21.2%、18.2%、18.2%、12.1%;两组患者的简化急性生理学评分Ⅱ(SAPSⅡ)、5d内发生急性呼吸窘迫综合征(ARDS)的例数、机械通气时间、住ICU时间及预后比较,差异有统计学意义(P0.05)。结论 SAPSⅡ评分高及发生ARDS的患者发生迟发型VAP的概率更高,鉴于迟发型VAP患者二重感染的发生率更高,临床可能更需要联合用药。
[Abstract]:Objective to analyze the clinical characteristics and the distribution of pathogenic bacteria in delayed ventilator associated pneumonia (VAP) and compare it with early onset VAP in order to provide reference for clinical experience. Methods from March 2010 to November 2012, 103 patients with VAP were divided into early onset and delayed onset according to the time of onset of VAP. The clinical characteristics, etiology and prognosis of the two patients were analyzed by SPSS17.0 software. The measurement data were expressed as mean 卤standard deviation. T test and 蠂 2 test were used to compare the measurement data among groups. Results in the early onset VAP group, 58 cases were positive in sputum culture, the positive rate was 73.4%. 73 strains of pathogenic bacteria were isolated, including Acinetobacter baumannii, Burkholderia cepacia, Klebsiella pneumoniae. In the delayed type VAP group, 20 cases were positive in sputum culture, the positive rate was 83.3%, 33 strains of pathogenic bacteria were isolated, mainly Acinetobacter baumannii, Bacillus cepacia, Klebsiella pneumoniae, Pseudomonas aeruginosa. There were significant differences between the two groups in the number of patients with acute respiratory distress syndrome (ARDS), the duration of mechanical ventilation, the duration of ICU residence and prognosis within 5 days after the onset of acute respiratory distress syndrome (ARDS) in the two groups (P0.05). Conclusion patients with high SAPS 鈪，
本文编号：2226333
[Abstract]:Objective to analyze the clinical characteristics and the distribution of pathogenic bacteria in delayed ventilator associated pneumonia (VAP) and compare it with early onset VAP in order to provide reference for clinical experience. Methods from March 2010 to November 2012, 103 patients with VAP were divided into early onset and delayed onset according to the time of onset of VAP. The clinical characteristics, etiology and prognosis of the two patients were analyzed by SPSS17.0 software. The measurement data were expressed as mean 卤standard deviation. T test and 蠂 2 test were used to compare the measurement data among groups. Results in the early onset VAP group, 58 cases were positive in sputum culture, the positive rate was 73.4%. 73 strains of pathogenic bacteria were isolated, including Acinetobacter baumannii, Burkholderia cepacia, Klebsiella pneumoniae. In the delayed type VAP group, 20 cases were positive in sputum culture, the positive rate was 83.3%, 33 strains of pathogenic bacteria were isolated, mainly Acinetobacter baumannii, Bacillus cepacia, Klebsiella pneumoniae, Pseudomonas aeruginosa. There were significant differences between the two groups in the number of patients with acute respiratory distress syndrome (ARDS), the duration of mechanical ventilation, the duration of ICU residence and prognosis within 5 days after the onset of acute respiratory distress syndrome (ARDS) in the two groups (P0.05). Conclusion patients with high SAPS 鈪，
本文编号：2226333
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