【摘要】：目的:探討無創(chuàng)機(jī)械通氣患者發(fā)生醫(yī)院獲得性肺炎(hospital acquired pneumonia,HAP)的相關(guān)危險因素,從而為臨床實(shí)施干預(yù)提供參考依據(jù)。方法:回顧性分析某三甲醫(yī)院2014年12月至2016年2月呼吸內(nèi)科重癥監(jiān)護(hù)室440例無創(chuàng)機(jī)械通氣患者的臨床資料,采用logistic回歸分析發(fā)生HAP的高危因素。結(jié)果:440例無創(chuàng)機(jī)械通氣患者中發(fā)生HAP15例,感染發(fā)生率為3.41%;單因素分析結(jié)果顯示,合并糖尿病、APACHEⅡ評分18分、ICU住院天數(shù)10 d、無創(chuàng)機(jī)械通氣時間7 d、血清白蛋白水平低于25 g/L、留置胃管、呼吸機(jī)管路使用時間7 d以及人工吸痰都與無創(chuàng)機(jī)械通氣患者發(fā)生HAP具有相關(guān)性(P0.05);多因素分析結(jié)果顯示,APACHEⅡ評分18分(OR=4.665,95%CI=1.2~18.134,P=0.026)、ICU住院天數(shù)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)是無創(chuàng)機(jī)械通氣患者發(fā)生HAP的獨(dú)立危險因素。結(jié)論:病情危重、ICU住院時間較長(10 d)以及患者自主排痰能力較差需人工吸痰的無創(chuàng)機(jī)械通氣患者發(fā)生HAP的感染率較高,如果患者存在以上危險因素,應(yīng)加強(qiáng)對HAP的預(yù)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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