CAJ | 학술논문

目的探讨重症加强治疗病房(Intensive Care Unit,ICU)呼吸机相关肺炎(ventilator-associated pneumonia,VAP)的发病机制、易感致病因素及防护措施.方法回顾性分析本院ICU收治的112例呼吸机使用患者,收集患者临床详细资料,同时收集患者的口咽部、声门下分泌物、呼吸道痰液以及胃液进行培养和药敏检测,分析VAP的病源和危险因素,探讨其防治措施.结果 VAP患者的病原菌主要为G-菌,年龄、患者身体素质、呼吸机持续时间、口腔洁净度、鼻胃管是否滞留、糖皮质激素、制酸剂、抗菌药物的使用等为其易感因素.结论菌群易位或比例失调是VAP发病的主要机制,胃-咽-下呼吸道的逆行感染为VAP的重要感染途径,此外,还受患者年龄、体质及药物使用等影响,可以通过调控其易感因素有效控制VAP的发病率.
목적탐토중증가강치료병방(Intensive Care Unit,ICU)호흡궤상관폐염(ventilator-associated pneumonia,VAP)적발병궤제、역감치병인소급방호조시.방법회고성분석본원ICU수치적112례호흡궤사용환자,수집환자림상상세자료,동시수집환자적구인부、성문하분비물、호흡도담액이급위액진행배양화약민검측,분석VAP적병원화위험인소,탐토기방치조시.결과 VAP환자적병원균주요위G-균,년령、환자신체소질、호흡궤지속시간、구강길정도、비위관시부체류、당피질격소、제산제、항균약물적사용등위기역감인소.결론균군역위혹비례실조시VAP발병적주요궤제,위-인-하호흡도적역행감염위VAP적중요감염도경,차외,환수환자년령、체질급약물사용등영향,가이통과조공기역감인소유효공제VAP적발병솔.
@@@@Objective To investigate the pathogenesis, pathogenic factors, and protective measures of Ventilator-associated Pneumonia in ICU. Methods Study on 112 patients with VAP in ICU, collected their age, sex, duration of ventilation, surgery and medication; then collected the secretions of oropharyngeal and subglottic, respiratory mucus and gastric juice with a quantitative method cultured and their antibiotic susceptibility was detected. Analysed the source of the disease and risk factors of VAP, and its prevention measures. Results Pathogenic bacteria of VAP in ICU mostly were G-, the predisposing factors were age, the physical of Patients, ventilator duration, oral cleanliness, nasogastric tube is stranded, corticosteroids, antacids, use of antimicrobial drugs. Conclusion The pathogenesis of VAP is bacterial translocation or imbalance, the important route of infection is retrograde infection of stomach-pharynx-the lower respiratory tract. In addition, the patient's age, physical fitness, and drug use are influencing factors. By regulating the predisposing factors to effectively control the incidence of VAP.