本文選題：機(jī)械通氣 + 重癥監(jiān)護(hù)病房�。� 參考：《中華醫(yī)院感染學(xué)雜志》2016年01期

【摘要】：目的探討ICU機(jī)械通氣患者發(fā)生呼吸機(jī)相關(guān)性肺炎(VAP)的危險因素及干預(yù)措施,為降低VAP發(fā)生率提供依據(jù)。方法回顧性分析2013年3月-2014年4月醫(yī)院收治的360例ICU機(jī)械通氣患者臨床資料,分析其病原菌分布及相關(guān)危險因素;采用SPSS19.0軟件對數(shù)據(jù)進(jìn)行統(tǒng)計分析,計數(shù)資料比較用χ2或校正χ2檢驗及Fisher′s精確概率法;對VAP影響因素分析采用單因素與多因素logistic回歸分析。結(jié)果 360例ICU機(jī)械通氣患者發(fā)生VAP 118例,發(fā)生率為32.78%;共檢出病原菌142株,其中革蘭陰性菌91株占64.08%,以鮑氏不動桿菌、銅綠假單胞菌為主,革蘭陽性菌47株占33.10%,以金黃色葡萄球菌為主,真菌5株占3.52%,以白色假絲酵母菌為主;單因素及多因素logistic回歸分析發(fā)現(xiàn),年齡60歲、機(jī)械通氣時間5d、血清白蛋白含量30g/L、APACHEⅡ評分18分、有意識障礙、應(yīng)用制酸劑、侵入性操作、留置胃管等因素是發(fā)生VAP的獨立危險因素(P0.05)。結(jié)論 ICU機(jī)械通氣患者發(fā)生呼吸機(jī)相關(guān)性肺炎危險因素較多,應(yīng)采取針對性措施,嚴(yán)密監(jiān)控,加強(qiáng)護(hù)理措施,以降低VAP發(fā)生率。
[Abstract]:Objective to explore the risk factors and intervention measures of ventilator associated pneumonia (VAP) in patients with mechanical ventilation in ICU, and to provide evidence for reducing the incidence of VAP. Methods the clinical data of 360 patients with mechanical ventilation in ICU from March 2013 to April 2014 were retrospectively analyzed, the distribution of pathogenic bacteria and related risk factors were analyzed, and the data were statistically analyzed by SPSS 19.0 software. The count data were compared by 蠂 ~ 2 test or correction 蠂 ~ 2 test and Fisher's exact probability method, and univariate and multi-factor logistic regression analysis were used to analyze the influencing factors of logistic. Results there were 118 cases of VAP in 360 patients with mechanical ventilation in ICU, the incidence rate was 32.788.142 strains of pathogenic bacteria were detected, of which 91 strains were Gram-negative bacteria, mainly Acinetobacter baumannii and Pseudomonas aeruginosa. There were 47 Gram-positive bacteria (33.10%), mainly Staphylococcus aureus, 5 fungi (3.52%) and Candida albicans. Univariate and multivariate logistic regression analysis showed that the age was 60 years old. Mechanical ventilation time (5 days), serum albumin content (30 g / L) Apache 鈪，

本文編號：1997099