中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2014年
11期
1239-1243
,共5页
杨钧%王海燕%梁惠%奚晶晶%程芮
楊鈞%王海燕%樑惠%奚晶晶%程芮
양균%왕해연%량혜%해정정%정예
呼吸机相关性肺炎%危险因素%机械通气%前瞻性研究
呼吸機相關性肺炎%危險因素%機械通氣%前瞻性研究
호흡궤상관성폐염%위험인소%궤계통기%전첨성연구
Ventilator-associated pneumonia%Risk factor%Mechanical ventilation%Prospective study
目的 研究呼吸机相关性肺炎(VAP)发生的危险因素.方法 采用前瞻性队列研究,对2007年6月至2010年5月武警总医院ICU收治的78例需要经口气管插管机械通气的成年患者进行连续观察.入选病例分别记录患者因素、医源性因素、营养状况等相关的临床因素,并进行多因素Logistic回归分析.结果 78例患者中,VAP发病率23.1％,病死率22.2％;多因素Logistic回归分析发现,预防性抗生素治疗(OR=6.038;95％CI:1.319～27.641; P=0.021),使用糖皮质激素(OR=5.385;95％CI:1.191～24.346;P=0.029),前白蛋白降低(≤69.7 mg/L)(OR=0.975;95％ CI:0.956～0.995;P=0.013)差异具有统计学意义.结论 PA降低(≤69.7 mg/L),预防性抗生素治疗和使用糖皮质激素是VAP发生的独立危险因素.
目的 研究呼吸機相關性肺炎(VAP)髮生的危險因素.方法 採用前瞻性隊列研究,對2007年6月至2010年5月武警總醫院ICU收治的78例需要經口氣管插管機械通氣的成年患者進行連續觀察.入選病例分彆記錄患者因素、醫源性因素、營養狀況等相關的臨床因素,併進行多因素Logistic迴歸分析.結果 78例患者中,VAP髮病率23.1％,病死率22.2％;多因素Logistic迴歸分析髮現,預防性抗生素治療(OR=6.038;95％CI:1.319～27.641; P=0.021),使用糖皮質激素(OR=5.385;95％CI:1.191～24.346;P=0.029),前白蛋白降低(≤69.7 mg/L)(OR=0.975;95％ CI:0.956～0.995;P=0.013)差異具有統計學意義.結論 PA降低(≤69.7 mg/L),預防性抗生素治療和使用糖皮質激素是VAP髮生的獨立危險因素.
목적 연구호흡궤상관성폐염(VAP)발생적위험인소.방법 채용전첨성대렬연구,대2007년6월지2010년5월무경총의원ICU수치적78례수요경구기관삽관궤계통기적성년환자진행련속관찰.입선병례분별기록환자인소、의원성인소、영양상황등상관적림상인소,병진행다인소Logistic회귀분석.결과 78례환자중,VAP발병솔23.1％,병사솔22.2％;다인소Logistic회귀분석발현,예방성항생소치료(OR=6.038;95％CI:1.319～27.641; P=0.021),사용당피질격소(OR=5.385;95％CI:1.191～24.346;P=0.029),전백단백강저(≤69.7 mg/L)(OR=0.975;95％ CI:0.956～0.995;P=0.013)차이구유통계학의의.결론 PA강저(≤69.7 mg/L),예방성항생소치료화사용당피질격소시VAP발생적독립위험인소.
Objective To analysis the risk factors in ventilator-associated pneumonia (VAP) in mechanically ventilated patients.Methods Seventy-eight adult inpatients on mechanical ventilation (MV) through oral endotracheal intubation were studied prospectively by observation between June,2007 and May,2010.Clinical associated factors including patients'predisposition related,medical personnel or device related and nutritional state related factors,etc.were recorded and analyzed.Results In 78 ventilated patients,the incidence of VAP was 23.1％,the fatality rate was 22.2％.Preventive antibiotic treatment (OR=6.038; 95％ CI:1.319-27.641; P =0.021),applying glucocorticoid (OR =5.385; 95％ CI:1.191-24.346; P =0.029) and prealbumin (PA) ≤ 69.7 mg/L (OR =0.975; 95％ CI:0.956-0.995 ; P =0.013) were risk factors in VAP.Conclusions The risk factors in VAP were PA ≤ 69.7mg/L,preventive antibiotic treatment and employment of glucocorticoid.
