本文選題：機械通氣 + 呼吸機相關(guān)肺炎　； 參考：《中華醫(yī)院感染學雜志》2014年20期

【摘要】：目的探討不同聲門下積液清除方法對下呼吸道細菌數(shù)和呼吸機相關(guān)性肺炎(VAP)發(fā)生率、機械通氣(MV)時間、ICU入住時間、病死率的影響,為臨床預防VAP提供參考。方法對2011年1-12月入住綜合ICU行機械通氣48h的57例患者進行研究,按隨機數(shù)字表法分為A組30例、B組27例,A組在常規(guī)氣道護理的基礎上進行聲門下沖洗;B組在常規(guī)氣道護理的基礎上進行聲門下聯(lián)合口咽部沖洗,分別于MV48h、4、7d收集氣囊滯留物和下呼吸道分泌物進行細菌培養(yǎng),觀察MV患者VAP發(fā)生率、MV時間、ICU入住時間、病死率,采用SPSS17.0軟件進行統(tǒng)計分析。結(jié)果 MV5dVAP發(fā)生率A組為46.67%、B為14.82%,差異有統(tǒng)計學意義(P0.05),MV≥5dVAP發(fā)生率A組為70.00%、B為51.85%,差異無統(tǒng)計學意義;兩組患者MV時間、ICU入住時間、病死率比較差異無統(tǒng)計學意義,但發(fā)生與未發(fā)生VAP患者的MV時間、ICU入住時間比較,差異有統(tǒng)計學意義(P0.05);發(fā)生與未發(fā)生VAP患者的病死率比較,差異無統(tǒng)計學意義。結(jié)論聲門下聯(lián)合口咽部沖洗比單純聲門下沖洗能更有效地降低早發(fā)性VAP的發(fā)生率;VAP的發(fā)生可使重癥患者的MV時間、ICU入住時間明顯延長。
[Abstract]:Objective to investigate the effects of different subglottic effusion clearance methods on the bacterial count of lower respiratory tract, the incidence of ventilator-associated pneumonia (VAP), the time of mechanical ventilation (MV) and the time of ICU admission, and the mortality of ICU, so as to provide a reference for clinical prevention of VAP. Methods A total of 57 patients admitted to ICU for 48 hours from January to December 2011 were studied. According to the method of random digital table, group A (n = 30) and group B (n = 27) were divided into group A (n = 30) and group A (n = 27) undergoing subglottic irrigation on the basis of routine airway nursing and group B (n = 27) undergoing subglottic combined oropharynx washing on the basis of routine airway nursing. The bacterial culture of air bag retention and lower respiratory tract secretion were collected for 7 days after MV 48h. The incidence of VAP in MV patients and the time of ICU stay and mortality were observed. SPSS 17.0 software was used for statistical analysis. Results the incidence rate of MV 5d VAP in group A was 46.67 and 14.82B, the difference was statistically significant (P0.05) the incidence rate of MV 鈮，

本文編號：2109438