中华现代护理杂志
中華現代護理雜誌
중화현대호리잡지
CHINESE JOURNAL OF MODERN NURSING
2013年
21期
2531-2533
,共3页
戚少云%马兴好%刘正东%李玲
慼少雲%馬興好%劉正東%李玲
척소운%마흥호%류정동%리령
重症监护病房%肺炎,呼吸机相关性%危险因素%Logistic回归分析
重癥鑑護病房%肺炎,呼吸機相關性%危險因素%Logistic迴歸分析
중증감호병방%폐염,호흡궤상관성%위험인소%Logistic회귀분석
Intensive care unit%Ventilator-associated pneumonia%Risk factors%Logistic regression analysis
目的 探讨综合重症监护病房(ICU)呼吸机相关性肺炎(VAP)的危险因素,为预防控制VAP提供理论参考.方法 对某三级医院综合ICU 2011年1-12月所有持续机械通气时间≥48 h的患者进行监测,记录患者的临床流行病学特点和诊疗操作情况,应用多元Logistic回归方法分析VAP的危险因素.结果 共收集病例168例,其中VAP 60例,VAP的发生率为35.7％；单因素分析显示,胃肠内营养、机械通气类型、气管切开、合并其他部位感染、抗生素使用数量、呼吸机使用时间、总住院天数和ICU住院天数是VAP的重要危险因素；多因素Logistic回归分析显示,机械通气类型(OR=10.945,P＜0.05)、抗生素使用数量(OR=1.653,P＜0.01)和ICU住院天数(OR=1.111,P＜0.01)是VAP的独立危险因素.结论 ICU患者是发生VAP的高危人群且危险因素较多,应采取针对性的措施,如尽量缩短机械通气的时间和ICU的住院时间、避免频繁更换抗生素、减少有创操作等,预防VAP的发生.
目的 探討綜閤重癥鑑護病房(ICU)呼吸機相關性肺炎(VAP)的危險因素,為預防控製VAP提供理論參攷.方法 對某三級醫院綜閤ICU 2011年1-12月所有持續機械通氣時間≥48 h的患者進行鑑測,記錄患者的臨床流行病學特點和診療操作情況,應用多元Logistic迴歸方法分析VAP的危險因素.結果 共收集病例168例,其中VAP 60例,VAP的髮生率為35.7％；單因素分析顯示,胃腸內營養、機械通氣類型、氣管切開、閤併其他部位感染、抗生素使用數量、呼吸機使用時間、總住院天數和ICU住院天數是VAP的重要危險因素；多因素Logistic迴歸分析顯示,機械通氣類型(OR=10.945,P＜0.05)、抗生素使用數量(OR=1.653,P＜0.01)和ICU住院天數(OR=1.111,P＜0.01)是VAP的獨立危險因素.結論 ICU患者是髮生VAP的高危人群且危險因素較多,應採取針對性的措施,如儘量縮短機械通氣的時間和ICU的住院時間、避免頻繁更換抗生素、減少有創操作等,預防VAP的髮生.
목적 탐토종합중증감호병방(ICU)호흡궤상관성폐염(VAP)적위험인소,위예방공제VAP제공이론삼고.방법 대모삼급의원종합ICU 2011년1-12월소유지속궤계통기시간≥48 h적환자진행감측,기록환자적림상류행병학특점화진료조작정황,응용다원Logistic회귀방법분석VAP적위험인소.결과 공수집병례168례,기중VAP 60례,VAP적발생솔위35.7％；단인소분석현시,위장내영양、궤계통기류형、기관절개、합병기타부위감염、항생소사용수량、호흡궤사용시간、총주원천수화ICU주원천수시VAP적중요위험인소；다인소Logistic회귀분석현시,궤계통기류형(OR=10.945,P＜0.05)、항생소사용수량(OR=1.653,P＜0.01)화ICU주원천수(OR=1.111,P＜0.01)시VAP적독립위험인소.결론 ICU환자시발생VAP적고위인군차위험인소교다,응채취침대성적조시,여진량축단궤계통기적시간화ICU적주원시간、피면빈번경환항생소、감소유창조작등,예방VAP적발생.
Objective To investigate the risk factors and nursing strategy of ventilator-associated pneumonia (VAP) in intensive care unit (ICU),and provide reference for preventing and controlling VAP.Methods Totals of 168 cases with mechanical ventilation (MV) duration over 48 hours in ICU from Jan 2011 to Dec 2011 were studied.The clinical epidemiological characteristics and treatment process were recorded.The risk factors of VAP were analyzed by Logistic regression.Results Totally 60 VAP cases among 168 patients were collected,the incidence of VAP was 35.7％.The univariate analysis showed that enteral nutrition,mechanical ventilation type,tracheotomy,infections at other sites,the number of antibiotics,ventilator time and total hospital days and ICU days were important risk factors of VAP.Logistic regression analysis showed that mechanical ventilation type (OR =10.945,P ＜0.05),the number of antibiotics (OR =1.653,P ＜0.01) and ICU hospital days (OR =1.111,P ＜ 0.01) were independently associated with VAP.Conclusions Because of many risks factors,the patients in ICU are the high risk group of VAP.Specific measures should be taken to prevent the incidence of VAP,such as:reducing the duration of mechanical ventilation,ICU length of stay and invasive treatment Etc.
