中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2012年
2期
161-163
,共3页
张应金%苏永棉%梁凤潇%李剑峰%张金凤%黄冠芬%黄润忠
張應金%囌永棉%樑鳳瀟%李劍峰%張金鳳%黃冠芬%黃潤忠
장응금%소영면%량봉소%리검봉%장금봉%황관분%황윤충
呼吸机相关性肺炎%pH值%革兰阴性杆菌%婴儿,新生
呼吸機相關性肺炎%pH值%革蘭陰性桿菌%嬰兒,新生
호흡궤상관성폐염%pH치%혁란음성간균%영인,신생
Ventilator-associated pneumonia%pH value%Gram-negative bacillus%Infant,newborn
目的 分析不同胃液pH值情况下,呼吸机相关性肺炎(ventilator associated pneumonia,VAP)的病原学及发病情况,探讨VAP的内源性发病机制.方法 选取我院新生儿重症监护病房2008年12月至2010年12月收治的98例患儿,按是否发生VAP,分为VAP组(52例)及非VAP组(46例).观察两组患儿胃腔病原菌种类与胃液pH值的关系.结果 98例患儿中,发生VAP 52例,发生率为53.1％.胃液pH值影响胃腔定植菌种类,当胃液pH值≤4时,胃腔定植菌主要为念珠菌和革兰阳性杆菌；胃液pH值＞4时,胃腔内革兰阴性杆菌检出率明显上升.胃液pH值≤4时,VAP发生率为34.5％ (10/29)；pH值＞4时,VAP发生率为60.9％(42/69).pH值＞4时VAP的发生率显著高于pH值≤4时VAP的发生率(x2 =5.71,P=0.017).结论 胃液pH值是影响胃腔定植菌,特别是多重耐药的产超广谱β-内酰胺酶菌等革兰阴性杆菌定植的重要因素.胃液pH值越高,VAP发生率越高.
目的 分析不同胃液pH值情況下,呼吸機相關性肺炎(ventilator associated pneumonia,VAP)的病原學及髮病情況,探討VAP的內源性髮病機製.方法 選取我院新生兒重癥鑑護病房2008年12月至2010年12月收治的98例患兒,按是否髮生VAP,分為VAP組(52例)及非VAP組(46例).觀察兩組患兒胃腔病原菌種類與胃液pH值的關繫.結果 98例患兒中,髮生VAP 52例,髮生率為53.1％.胃液pH值影響胃腔定植菌種類,噹胃液pH值≤4時,胃腔定植菌主要為唸珠菌和革蘭暘性桿菌；胃液pH值＞4時,胃腔內革蘭陰性桿菌檢齣率明顯上升.胃液pH值≤4時,VAP髮生率為34.5％ (10/29)；pH值＞4時,VAP髮生率為60.9％(42/69).pH值＞4時VAP的髮生率顯著高于pH值≤4時VAP的髮生率(x2 =5.71,P=0.017).結論 胃液pH值是影響胃腔定植菌,特彆是多重耐藥的產超廣譜β-內酰胺酶菌等革蘭陰性桿菌定植的重要因素.胃液pH值越高,VAP髮生率越高.
목적 분석불동위액pH치정황하,호흡궤상관성폐염(ventilator associated pneumonia,VAP)적병원학급발병정황,탐토VAP적내원성발병궤제.방법 선취아원신생인중증감호병방2008년12월지2010년12월수치적98례환인,안시부발생VAP,분위VAP조(52례)급비VAP조(46례).관찰량조환인위강병원균충류여위액pH치적관계.결과 98례환인중,발생VAP 52례,발생솔위53.1％.위액pH치영향위강정식균충류,당위액pH치≤4시,위강정식균주요위념주균화혁란양성간균；위액pH치＞4시,위강내혁란음성간균검출솔명현상승.위액pH치≤4시,VAP발생솔위34.5％ (10/29)；pH치＞4시,VAP발생솔위60.9％(42/69).pH치＞4시VAP적발생솔현저고우pH치≤4시VAP적발생솔(x2 =5.71,P=0.017).결론 위액pH치시영향위강정식균,특별시다중내약적산초엄보β-내선알매균등혁란음성간균정식적중요인소.위액pH치월고,VAP발생솔월고.
Objective To investigate the pathogen and incidence of ventilator-associated pneumonia (VAP) under different pH value of gastric juice,and to explore the endogenous pathogenesis of VAP.Methods Ninety-eight cases were admitted in our neonatal intensive care unit from Dec 2008 to Dec 2010.According to whether VAP happened,they were divided into VAP group (52 cases) and non-VAP group (46 cases).The relation between pH value of gastric juice and the species of pathogenic bacteria in stomach was analyzed.Results The incidence of VAP was 53.1％ (52/98).The pH value of gastric juice affected the species of pathogenic bacteria in stomach.When pH ≤ 4,the major species of pathogenic bacteria were Candida and Gram-positive bacillus; and pH ＞ 4,the major species were Gram-negative bacillus.The incidence of VAP was 34.5％ (10/29) when pH≤4;on the contrary,the incidence was 60.9％ (42/69) when pH ＞ 4.The incidence of VAP at the time of pH ＞ 4 was significantly higher than that of pH ≤4 ( x2 =5.71,P =0.017).Conclusion The pH value of gastric juice is an important factor of the species of pathogenic bacteria in stomach,especially for Gram-negative bacillus,including multi-drug resistant extended-spectrum β-lactamase-producing bacteria.The higher of pH value,the incidence of VAP is higher.
