新生儿呼吸机相关性肺炎研究进展
|
摘要
呼吸机相关性肺炎(ventilator-assiciatied pneumonia,VAP)是机械通气常见的严重并发症,新生儿重症监护病房(neonatal intensive care unit,NICU)是发生医院感染的高危科室,是医院感染预防控制的重点部门。随着呼吸机在新生儿重症监护室的广泛使用,新生儿VAP的发生率有逐年增多的趋势。患儿发生VAP对其生存率、病死率、住院费用和住院时间的长短都有很大的影响。明确新生儿VAP的危险因素,实施全面综合的预防控制措施、及时准确的诊断以及迅速有效的治疗措施在临床工作中至关重要,也是亟待解决的医疗难题。
Ventilator-associated pneumonia(VAP)is a common severe complication induced by mechanical ventilation,the neonatal intensive care unit(NICU)is a department at high risk of nosocomial infection and is the key department to prevent and control nosocomial infection.With the widespread use of ventilators in the NICU,the incidence of VAP is increased among the neonates year by year.The VAP may have great impact on the survival rate,mortality rate,hospitalization cost and length of hospital stay of the neonates.It is crucial to define the risk factors for the VAP,carry out comprehensive prevention and control measures,accurately diagnose in a timely manner and take effective treatment measures,and the VAP in the neonates is also a medical difficulty that needs to be settled.
Ventilator-associated pneumonia(VAP)is a common severe complication induced by mechanical ventilation,the neonatal intensive care unit(NICU)is a department at high risk of nosocomial infection and is the key department to prevent and control nosocomial infection.With the widespread use of ventilators in the NICU,the incidence of VAP is increased among the neonates year by year.The VAP may have great impact on the survival rate,mortality rate,hospitalization cost and length of hospital stay of the neonates.It is crucial to define the risk factors for the VAP,carry out comprehensive prevention and control measures,accurately diagnose in a timely manner and take effective treatment measures,and the VAP in the neonates is also a medical difficulty that needs to be settled.
引文
[1] Garland JS.Strategies to prevent ventilator-associated pneumonia in neonates[J].Clin Perinatol,2010,37:629-643.
[2]中华医学会重症医学分会.呼吸机相关性肺炎诊断预防和治疗指南(2013)[J].中华内科杂志,2013,52(6):524-543.
[3]吴金凤,姜方,王锟.综合干预策略预防新生儿呼吸机相关性肺炎感染的临床应用[J].中华医院感染学杂志,2017,27(24):5673-5676.
[4]姜岚,杨志龙.新生儿呼吸机相关性肺炎的临床分析[J].浙江临床医学,2014,8(2):286-287.
[5] Dudeck MA,Weiner LM,Allen-Bridson K,et al.National Healthcare Safety Network(NHSN)report,data summary for 2012,device-associated module[J].Am J Infect Control,2013,41(12):1148-1166.
[6] Mir Z,Ali I,Qureshi O,et al.Risk factors,pathogen profile and outcome of ventilator associated pneumonia in a neonatal intensive care unit[J].Int J Contemp Pediatrics,2015,2(1):17-20.
[7]钟斌.新生儿呼吸机相关肺炎的危险因素与防治策略[J].世界临床医学,2016,10(12):144-147.
[8]徐南.新生儿呼吸机相关性肺炎的高危因素Logistic回归分析[J].实用临床医药杂志,2016,20(11):87-90.
[9]梁振明,朱亚菲,朱银燕.新生儿呼吸机相关性肺炎的危险因素分析[J].中华医院感染学杂志,2015,25(1):232-234.
[10]谭斌,张帆,黄娅铃,等.新生儿呼吸机相关性肺炎危险因素的Meta分析[J].重庆医学2014,43(14):1693-1696,1699.
[11]吕华,吴秀英,王燕儿.NICU呼吸机相关性肺炎病原学分析[J].中华医院感染学杂志,2012,22(1):182-184.
[12]随素云,云磊,魏广友.NICU新生儿呼吸机相关肺炎病原菌分布与耐药性分析[J].中华医院感染学杂志,2016,26(5):1138-1140.
[13] Thakuria B,Singh P,Agrawal S,et al.Profile of infective microorganisms causing ventilator-associated pneumonia:a clinical study from resource limited intensive care unit[J].Anaesthesiol Clin Pharmacol,2013,29(3):361-366.
[14]罗惠玲,白波,李广宏,等.新生儿呼吸机相关性肺炎病原菌与耐药性分析[J].国际检验医学杂志,2015,36(19):2791-2793.
[15]涂芳芳,曾绮丹,杨芳.新生儿呼吸机相关性肺炎的发生因素及病原菌分析[J].中华医院感染学杂志,2014,24(11):2824-2828.
[16]中华人民共和国卫生部医疗服务标准专业委员会.肺炎诊断[S].北京:中华人民共和国卫生部,2012.
[17]耿文静,刘红.新生儿呼吸机相关性肺炎诊疗进展[J].中国新生儿科杂志,2013,28(5):349-352.
[18] TorresA,Fabregas N,Ewig S,et al.Sampling methods for ventilator-associated pneumonia:validation using different histologic and microbiological references[J].Crit Care Med,2007,28(8):2799-2804.
[19] Larrabee JH,Janney MA,Ostruw CL,et al.Predicting registered nurse job satisfaction and intent to leave[J].J Nurs Adm,2003,33(5):271-283.
[20] Badr MA,Ali YF,Albanna EA,et al.Ventilator-associated pneumonia in critically-ill neonates admitted to neonatal intensive care unit,Zagazig University Hospitals[J].Iran J Pediatr,2011,21(4):418-424.
[21]汪瑾,巨容.新生儿呼吸机相关性肺炎的预防措施[J].临床儿科杂志,2014,32(5):494-497.
[22]徐锦.新生儿呼吸机相关性肺炎的临床分析[J].中国临床医学,2014,7(3):240-242.
[23]寇秋野,张晓菲.重新认识选择性消化道去污[M].北京:人民卫生出版社,2011:78-82.
[24]叶春燕,吴凡伟,郭冀丹.碳酸氢钠口腔护理预防新生儿呼吸机相关性肺炎的效果观察[J].儿科护理,2017,19(7A):50-52.
[25] Liberati A,D′Amico R,Pifferi S,et al.Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care[J].Cochrane Database Syst Rev,2009(4):CD000022.
[26]石小娟,汪晓萍,曹爱芬.不同吸痰方法在新生儿呼吸机相关性肺炎中的应用效果比较[J].海南医学,2012,23(6):148-149.
[27]周启侠.目标性监测中集束化干预措施对降低呼吸机相关性肺炎发生率的研究[J].中华医院感染学杂志,2013,23(7):1543-1544.
[2]中华医学会重症医学分会.呼吸机相关性肺炎诊断预防和治疗指南(2013)[J].中华内科杂志,2013,52(6):524-543.
[3]吴金凤,姜方,王锟.综合干预策略预防新生儿呼吸机相关性肺炎感染的临床应用[J].中华医院感染学杂志,2017,27(24):5673-5676.
[4]姜岚,杨志龙.新生儿呼吸机相关性肺炎的临床分析[J].浙江临床医学,2014,8(2):286-287.
[5] Dudeck MA,Weiner LM,Allen-Bridson K,et al.National Healthcare Safety Network(NHSN)report,data summary for 2012,device-associated module[J].Am J Infect Control,2013,41(12):1148-1166.
[6] Mir Z,Ali I,Qureshi O,et al.Risk factors,pathogen profile and outcome of ventilator associated pneumonia in a neonatal intensive care unit[J].Int J Contemp Pediatrics,2015,2(1):17-20.
[7]钟斌.新生儿呼吸机相关肺炎的危险因素与防治策略[J].世界临床医学,2016,10(12):144-147.
[8]徐南.新生儿呼吸机相关性肺炎的高危因素Logistic回归分析[J].实用临床医药杂志,2016,20(11):87-90.
[9]梁振明,朱亚菲,朱银燕.新生儿呼吸机相关性肺炎的危险因素分析[J].中华医院感染学杂志,2015,25(1):232-234.
[10]谭斌,张帆,黄娅铃,等.新生儿呼吸机相关性肺炎危险因素的Meta分析[J].重庆医学2014,43(14):1693-1696,1699.
[11]吕华,吴秀英,王燕儿.NICU呼吸机相关性肺炎病原学分析[J].中华医院感染学杂志,2012,22(1):182-184.
[12]随素云,云磊,魏广友.NICU新生儿呼吸机相关肺炎病原菌分布与耐药性分析[J].中华医院感染学杂志,2016,26(5):1138-1140.
[13] Thakuria B,Singh P,Agrawal S,et al.Profile of infective microorganisms causing ventilator-associated pneumonia:a clinical study from resource limited intensive care unit[J].Anaesthesiol Clin Pharmacol,2013,29(3):361-366.
[14]罗惠玲,白波,李广宏,等.新生儿呼吸机相关性肺炎病原菌与耐药性分析[J].国际检验医学杂志,2015,36(19):2791-2793.
[15]涂芳芳,曾绮丹,杨芳.新生儿呼吸机相关性肺炎的发生因素及病原菌分析[J].中华医院感染学杂志,2014,24(11):2824-2828.
[16]中华人民共和国卫生部医疗服务标准专业委员会.肺炎诊断[S].北京:中华人民共和国卫生部,2012.
[17]耿文静,刘红.新生儿呼吸机相关性肺炎诊疗进展[J].中国新生儿科杂志,2013,28(5):349-352.
[18] TorresA,Fabregas N,Ewig S,et al.Sampling methods for ventilator-associated pneumonia:validation using different histologic and microbiological references[J].Crit Care Med,2007,28(8):2799-2804.
[19] Larrabee JH,Janney MA,Ostruw CL,et al.Predicting registered nurse job satisfaction and intent to leave[J].J Nurs Adm,2003,33(5):271-283.
[20] Badr MA,Ali YF,Albanna EA,et al.Ventilator-associated pneumonia in critically-ill neonates admitted to neonatal intensive care unit,Zagazig University Hospitals[J].Iran J Pediatr,2011,21(4):418-424.
[21]汪瑾,巨容.新生儿呼吸机相关性肺炎的预防措施[J].临床儿科杂志,2014,32(5):494-497.
[22]徐锦.新生儿呼吸机相关性肺炎的临床分析[J].中国临床医学,2014,7(3):240-242.
[23]寇秋野,张晓菲.重新认识选择性消化道去污[M].北京:人民卫生出版社,2011:78-82.
[24]叶春燕,吴凡伟,郭冀丹.碳酸氢钠口腔护理预防新生儿呼吸机相关性肺炎的效果观察[J].儿科护理,2017,19(7A):50-52.
[25] Liberati A,D′Amico R,Pifferi S,et al.Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care[J].Cochrane Database Syst Rev,2009(4):CD000022.
[26]石小娟,汪晓萍,曹爱芬.不同吸痰方法在新生儿呼吸机相关性肺炎中的应用效果比较[J].海南医学,2012,23(6):148-149.
[27]周启侠.目标性监测中集束化干预措施对降低呼吸机相关性肺炎发生率的研究[J].中华医院感染学杂志,2013,23(7):1543-1544.