本文選題：重癥監(jiān)護(hù)病房 + 呼吸機(jī)相關(guān)肺炎��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年13期

【摘要】：目的了解重癥監(jiān)護(hù)病房(ICU)呼吸機(jī)相關(guān)肺炎(VAP)的發(fā)病率及相關(guān)危險因素,為臨床制定預(yù)防VAP防控措施提供依據(jù)。方法采用統(tǒng)一設(shè)計、多中心合作的方法,對部隊19所三級甲等綜合醫(yī)院6個類型27個ICU開展前瞻性監(jiān)測,監(jiān)測對象為2015年6月-2016年5月所有入住ICU并插管使用呼吸機(jī)的患者。結(jié)果共監(jiān)測患者3488例,發(fā)生VAP393例,發(fā)病率為11.27%;住院總?cè)諗?shù)為128572d,插管總?cè)諗?shù)40114d,VAP千日感染率為9.80‰,呼吸機(jī)使用率為31.20%;不同類型ICU VAP發(fā)病率為4.91%~26.95%,千日感染率為5.74‰~34.79‰;病死率為25.45%,治愈率為2.80%;單因素結(jié)果顯示,VAP相關(guān)危險因素與年齡、住ICU天數(shù)、基礎(chǔ)疾病數(shù)量、機(jī)械通氣時間、置管次數(shù)和口腔清潔次數(shù)有關(guān)(P0.05);多因素logistic回歸分析結(jié)果顯示,住ICU天數(shù)、機(jī)械通氣時間、置管次數(shù)是VAP發(fā)生的獨(dú)立危險因素;共檢出446株病原菌,其中革蘭陰性菌占89.01%,革蘭陽性菌占7.17%,真菌占3.81%。結(jié)論通過開展"醫(yī)院感染預(yù)防與控制能力建設(shè)"項(xiàng)目,明確發(fā)生VAP的相關(guān)危險因素,有針對性地制定防控措施和規(guī)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，

本文編號：1997195