CAJ | 학술논문

目的：探讨呼吸机相关性肺炎(VAP)的危险因素及病原学特点，为今后的临床工作提供参考依据。方法：收治机械通气治疗时间＞48小时的患者53例，分析VAP的危险因素、病原菌及耐药性。结果：53例患者中VAP患者23例(43.4%)。糖尿病、气管切开患者VAP的发病率增高(P＜0.05)；VAP组病死率明显高于无VAP组(P＜0.05)；VAP病原菌以革兰阴性菌为主(66.7%)，其中以鲍曼不动杆菌为主要致病菌(21.4%)，大多数病原菌出现严重耐药。结论：多种临床因素与 VAP 的发病有关，其主要危险因素为机械通气时间的长短；VAP 病原菌以革兰阴性菌为主，耐药率高；VAP的发生严重影响患者的预后，应加强预防工作，降低VAP发生率及死亡率。
목적：탐토호흡궤상관성폐염(VAP)적위험인소급병원학특점，위금후적림상공작제공삼고의거。방법：수치궤계통기치료시간＞48소시적환자53례，분석VAP적위험인소、병원균급내약성。결과：53례환자중VAP환자23례(43.4%)。당뇨병、기관절개환자VAP적발병솔증고(P＜0.05)；VAP조병사솔명현고우무VAP조(P＜0.05)；VAP병원균이혁란음성균위주(66.7%)，기중이포만불동간균위주요치병균(21.4%)，대다수병원균출현엄중내약。결론：다충림상인소여 VAP 적발병유관，기주요위험인소위궤계통기시간적장단；VAP 병원균이혁란음성균위주，내약솔고；VAP적발생엄중영향환자적예후，응가강예방공작，강저VAP발생솔급사망솔。
Objective:To Investigate the risk factors and etiology characteristics of ventilator associated pneumonia,and provide reference for future clinical work.Methods:53 patients with mechanical ventilation treatment time>48 hours were selected.We collected their clinical datas,and analyzed the risk factors,pathogenic bacteria and drug resistance of VAP.Results:In the 53 cases of patients,23 cases were VAP patients(43.4%).The morbidity of VAP in the patients with diabetes,tracheotomy increased(P<0.05);the mortality of VAP group was significantly higher than no VAP group(P<0.05);the main pathogenic bacteria of VAP was gram-negative bacteria(66.7%),among them,the acinetobacter baumannii was the main pathogenic bacteria(21.4%),most of patho-genic bacteria appear serious drug resistance.Conclusion:The various clinical factors are related to the incidence of VAP,the ma-jor risk factor is the mechanical ventilation time;the major VAP pathogens is gram negative bacteria,it has high resistance rate. The VAP has a serious impact on the prognosis of patients,we should strengthen the prevention,reduce the incidence and mortality.