呼吸机相关性肺炎病原菌的分布及危险因素分析
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摘要
目的调查呼吸机相关性肺炎(VAP)病原菌分布及相关危险因素,为预防VAP提供依据。方法选取2016年7月-2018年7月医院重症监护病房(ICU)行机械通气的150例患者资料进行回顾性分析,对其发生VAP的危险因素及病原菌的分布进行分析。结果 150例机械通气患者发生VAP 30例,发生率为20.0%;30例VAP患者送检痰标本,共检出病原菌32株,其中革兰阴性菌20株,占62.5%,革兰阳性菌10株,占31.2%,真菌2株,占6.2%;VAP的危险因素与年龄、慢性肺部疾病、机械通气时间、意识障碍、气管切开、侵袭性操作、抗菌药物的使用、住院时间等密切相关。结论 ICU患者发生VAP的危险因素较多,针对危险因素采取相应的预防措施,合理使用抗菌药物,加强无菌操作,可以明显减少VAP的发生。
Objective To investigate the risk factors and pathogens of ventilator-associated pneumonia(VAP) in ICU.Methods A retrospective study was conducted to analyze the clinical data of 150 patients who received mechanical ventilation in ICU during the period from July 2016 to July 2018. The risk factors of VAP and the distribution of pathogenic bacteria were examined. Results VAP was identified in 30(20.0%) of the 150 patients receiving mechanical ventilation. A total of 32 pathogens were isolated from the sputum of the 30 VAP patients, including 20(62.5%) strains of gram-negative bacteria and 10(31.2%)strains of gram-positive bacteria, and 2(6.2%) fungal strains. Patient age, chronic lung disease, duration of mechanical ventilation,disturbance of consciousness, tracheotomy, invasive procedure, application of antimicrobial agents, length of hospital stay were potential risk factors for VAP. Conclusions There are a number of risk factors for VAP in ICU patients. Corresponding preventive measures should be taken to restrict these factors. Rational use of antimicrobial agents and strict aseptic technique are helpful to reduce the occurrence of VAP.
Objective To investigate the risk factors and pathogens of ventilator-associated pneumonia(VAP) in ICU.Methods A retrospective study was conducted to analyze the clinical data of 150 patients who received mechanical ventilation in ICU during the period from July 2016 to July 2018. The risk factors of VAP and the distribution of pathogenic bacteria were examined. Results VAP was identified in 30(20.0%) of the 150 patients receiving mechanical ventilation. A total of 32 pathogens were isolated from the sputum of the 30 VAP patients, including 20(62.5%) strains of gram-negative bacteria and 10(31.2%)strains of gram-positive bacteria, and 2(6.2%) fungal strains. Patient age, chronic lung disease, duration of mechanical ventilation,disturbance of consciousness, tracheotomy, invasive procedure, application of antimicrobial agents, length of hospital stay were potential risk factors for VAP. Conclusions There are a number of risk factors for VAP in ICU patients. Corresponding preventive measures should be taken to restrict these factors. Rational use of antimicrobial agents and strict aseptic technique are helpful to reduce the occurrence of VAP.
引文
[1]韦艳，李晓阳，丁丽丽，等.重症监护病房呼吸机相关性肺炎的危险因素分析[J].中国感染与化疗杂志，2014, 14(1):7-10.
[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]王辉，韩芳，李茜. ICU呼吸机相关性肺炎危险因素及预防对策[J].中华医院感染学杂志，2014, 24(1):110-111, 121.
[4]孙彩霞. ICU呼吸机相关性肺炎的原因分析及护理对策[J].中华医院感染学杂志，2013, 23(5):1007-1009.
[5]刘东岩，孙铁英.集束化护理措施在呼吸机相关性肺炎患者中应用效果[J].中国医药导报，2013, 10(3):147-149.
[6]曹玉，孙伟，冷萍，等. ICU呼吸机相关性肺炎病原菌的构成及耐药性临床分析[J].中华医院感染学杂志，2009, 19(4):443-445.
[7]甘文思，王笑青，夏优秀，等. ICU呼吸机相关性肺炎的危险因素分析[J].中国消毒学杂志，2016, 33(5):451-453, 456.
[8]宋丽华，付翠艳，刘亚爽，等. ICU呼吸机相关性肺炎危险因素分析及预防措施探讨[J].实用临床医药杂志，2016, 20(9):50-53.
[9]陈虹. NICU呼吸机相关性肺炎危险因素及其护理干预措施的应用效果分析[J].齐齐哈尔医学院学报，2016, 37(1):138-139.
[10]王娟，李德宪，俞朝贤，等.结核重症监护室呼吸机相关性肺炎感染的危险因素分析[J].南方医科大学学报，2016, 36(5):719-723.
[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]王辉，韩芳，李茜. ICU呼吸机相关性肺炎危险因素及预防对策[J].中华医院感染学杂志，2014, 24(1):110-111, 121.
[4]孙彩霞. ICU呼吸机相关性肺炎的原因分析及护理对策[J].中华医院感染学杂志，2013, 23(5):1007-1009.
[5]刘东岩，孙铁英.集束化护理措施在呼吸机相关性肺炎患者中应用效果[J].中国医药导报，2013, 10(3):147-149.
[6]曹玉，孙伟，冷萍，等. ICU呼吸机相关性肺炎病原菌的构成及耐药性临床分析[J].中华医院感染学杂志，2009, 19(4):443-445.
[7]甘文思，王笑青，夏优秀，等. ICU呼吸机相关性肺炎的危险因素分析[J].中国消毒学杂志，2016, 33(5):451-453, 456.
[8]宋丽华，付翠艳，刘亚爽，等. ICU呼吸机相关性肺炎危险因素分析及预防措施探讨[J].实用临床医药杂志，2016, 20(9):50-53.
[9]陈虹. NICU呼吸机相关性肺炎危险因素及其护理干预措施的应用效果分析[J].齐齐哈尔医学院学报，2016, 37(1):138-139.
[10]王娟，李德宪，俞朝贤，等.结核重症监护室呼吸机相关性肺炎感染的危险因素分析[J].南方医科大学学报，2016, 36(5):719-723.