本文關(guān)鍵詞： 呼吸機(jī)相關(guān)肺炎 危險(xiǎn)因素 發(fā)病率 醫(yī)院感染 病例對(duì)照 前瞻性研究　出處：《中國感染控制雜志》2016年11期 　論文類型：期刊論文

【摘要】：目的了解呼吸機(jī)相關(guān)肺炎(VAP)發(fā)病率及其危險(xiǎn)因素,為預(yù)防VAP提供依據(jù)。方法對(duì)2006年1月—2011年12月2所三級(jí)甲等綜合醫(yī)院使用呼吸機(jī)患者開展VAP前瞻性監(jiān)測(cè),選取發(fā)生VAP醫(yī)院感染患者作為VAP組,未發(fā)生VAP醫(yī)院感染患者作為非VAP組(1∶1配比),進(jìn)行危險(xiǎn)因素分析。結(jié)果共監(jiān)測(cè)使用呼吸機(jī)患者2 550例,發(fā)生VAP475例,機(jī)械通氣總?cè)諗?shù)32 623 d,VAP發(fā)病率為14.56‰。單因素分析表明:反復(fù)呼吸道感染病史、1個(gè)月內(nèi)使用廣譜抗菌藥物、多次住院、昏迷、低蛋白血癥、脫機(jī)失敗后再次插管、使用糖皮質(zhì)激素、機(jī)械通氣5 d、誤吸、口腔衛(wèi)生情況差是VAP發(fā)生的危險(xiǎn)因素。多因素logistic回歸分析顯示,昏迷(OR95%CI:1.38~2.93)、低蛋白血癥(OR95%CI:1.12~2.10)、使用糖皮質(zhì)激素(OR95%CI:1.10~2.24)、脫機(jī)失敗再次插管(OR95%CI:2.14~4.74)、機(jī)械通氣5 d(OR95%CI:2.55~4.83)、誤吸(OR95%CI:1.24~2.77)、口腔衛(wèi)生情況差(OR95%CI:1.72~3.74)是VAP發(fā)生的獨(dú)立危險(xiǎn)因素。結(jié)論 VAP發(fā)病率較高,其危險(xiǎn)因素眾多,應(yīng)采取正確的口腔清潔、抬高頭位、及時(shí)評(píng)估撤機(jī)、改善營養(yǎng)狀況等綜合干預(yù)措施,降低VAP的發(fā)病率。
[Abstract]:Objective to investigate the incidence and risk factors of ventilator-associated pneumonia (VAP) and to provide evidence for the prevention of VAP. Methods VAP prospective monitoring was carried out on patients with ventilator in Grade 3A General Hospital from January 2006 to December 2nd 2011. Patients with nosocomial infection of VAP were selected as VAP group, patients with nosocomial infection of VAP were selected as proportion of 1: 1 in non-#en3# group, and the risk factors were analyzed. Results A total of 2 550 patients with ventilator were monitored and VAP475 cases were detected. The total number of days of mechanical ventilation was 32 623 days and the incidence of VAP was 14.56 鈥，

本文編號(hào)：1541172