CAJ | 학술논문

目的：探讨肿瘤患者呼吸机相关性肺炎发生的相关危险因素。方法机械通气呼吸机辅助呼吸的肿瘤患者98例，均机械通气＞48 h，以是否发生呼吸机相关性肺炎为判断标准分为感染组（30例）和非感染组（68例）。采用单因素分析2组间呼吸机相关性肺炎危险因素的差异，并进一步通过多因素Logistic回归分析影响呼吸机相关性肺炎发生的独立危险因素。结果单因素分析表明：感染组年龄、机械通气时间、应用激素、意识障碍、留置胃管、APACHEII评分及平卧位均高于非感染组（ P ＜0潩．05）。多因素分析表明：感染组年龄（OR＝1．087，95％CI 1．018～1．161）、机械通气时间（OR ＝5．148，95％CI 1．342～19．743）、留置胃管（OR＝1．074，95％CI 1．011～1．141）及APACHEII评分（OR＝1．336，95％CI 1．130～1．580）均高于非感染组（ P ＜0．05）。结论年龄大、机械通气时间长、留置胃管及APACHEⅡ评分高是发生呼吸机相关性肺炎的独立危险因素。
목적：탐토종류환자호흡궤상관성폐염발생적상관위험인소。방법궤계통기호흡궤보조호흡적종류환자98례，균궤계통기＞48 h，이시부발생호흡궤상관성폐염위판단표준분위감염조（30례）화비감염조（68례）。채용단인소분석2조간호흡궤상관성폐염위험인소적차이，병진일보통과다인소Logistic회귀분석영향호흡궤상관성폐염발생적독립위험인소。결과단인소분석표명：감염조년령、궤계통기시간、응용격소、의식장애、류치위관、APACHEII평분급평와위균고우비감염조（ P ＜0이．05）。다인소분석표명：감염조년령（OR＝1．087，95％CI 1．018～1．161）、궤계통기시간（OR ＝5．148，95％CI 1．342～19．743）、류치위관（OR＝1．074，95％CI 1．011～1．141）급APACHEII평분（OR＝1．336，95％CI 1．130～1．580）균고우비감염조（ P ＜0．05）。결론년령대、궤계통기시간장、류치위관급APACHEⅡ평분고시발생호흡궤상관성폐염적독립위험인소。
Objective To investigate the risk factors for ventilator associated pneumonia ( VAP) in oncology patients and improve the clinical medical security .Methods 98 cancer patients with mechanical ventilation ventilator-assisted breat-hing, they were underwent mechanical ventilation >48 h, depend on whether the occurrence of ventilator-associated pneumoni-a infections for judging standards , these patients are divided into infected groups (30 cases) and non-infected group (68 ca-ses) .Using Univariate analysis to analyses the difference in ventilator-associated pneumonia risk factors between the two groups, and further analyzed independent risk factors of ventilator-associated pneumonia by Logistic regression .Results Uni-variate analysis showed that:infection group's age, duration of mechanical ventilation, use of steroids, unconsciousness, in-dwelling stomach tube, APACHEII score and supine position were higher than non-infected group ( P <0.05).Multivariate analysis showed that:infected group's age (OR=1.087,95%CI 1.018-1.161), duration of mechanical ventilation (OR=5.148,95%CI 1.342-19.743),indwelling stomach tube (OR=1.074,95% CI 1.011-1.141) and APACHEII score (OR =1.336,95%CI 1.130-1.580) were higher than those of non-infected group ( P <0.05).Conclusion Older age, long time of mechanical ventilation , indwelling gastric tube and high APACHEⅡ score were the independent risk factor of VAP.