中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
34期
55-57,58
,共4页
雷艳萍%吾普尔·热合木吐力%马恩冒%郭桂林%吴有明
雷豔萍%吾普爾·熱閤木吐力%馬恩冒%郭桂林%吳有明
뢰염평%오보이·열합목토력%마은모%곽계림%오유명
ICU%机械通气%病原微生物%医院获得性肺炎中呼吸机相关肺炎
ICU%機械通氣%病原微生物%醫院穫得性肺炎中呼吸機相關肺炎
ICU%궤계통기%병원미생물%의원획득성폐염중호흡궤상관폐염
Intensive care unit%Mechanical ventilation%Pathogenic microorganisms%Hospital-acquired pneumonia in ventilator-associated pneumonia
目的：观察有创机械通气后引起医院获得性肺炎中呼吸机相关肺炎患者的主要致病菌。方法：选择55例患者分别在气管插管或切开机械通气后的不同时间，即：小于2 d、2 d后、拔管前，分析深部支气管分泌物细菌培养与药敏结果。结果：采集的129例标本中，有86例细菌培养阳性。共分离出细菌112株，其中革兰阴性杆菌占91.07%，以铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌、不动杆菌等为主，分别占39.28%、23.21%、7.14%、5.58%，为院内感染的主要致病菌，具有多耐药性及高耐药率。结论：有创机械通气易引起下呼吸道感染，导致医院获得性肺炎或呼吸机相关肺炎。因此，监测致病菌和及时药物敏感试验，有利于临床抗生素的选择及合理使用，从而降低院内感染和死亡率。
目的：觀察有創機械通氣後引起醫院穫得性肺炎中呼吸機相關肺炎患者的主要緻病菌。方法：選擇55例患者分彆在氣管插管或切開機械通氣後的不同時間，即：小于2 d、2 d後、拔管前，分析深部支氣管分泌物細菌培養與藥敏結果。結果：採集的129例標本中，有86例細菌培養暘性。共分離齣細菌112株，其中革蘭陰性桿菌佔91.07%，以銅綠假單胞菌、鮑曼不動桿菌、大腸埃希菌、不動桿菌等為主，分彆佔39.28%、23.21%、7.14%、5.58%，為院內感染的主要緻病菌，具有多耐藥性及高耐藥率。結論：有創機械通氣易引起下呼吸道感染，導緻醫院穫得性肺炎或呼吸機相關肺炎。因此，鑑測緻病菌和及時藥物敏感試驗，有利于臨床抗生素的選擇及閤理使用，從而降低院內感染和死亡率。
목적：관찰유창궤계통기후인기의원획득성폐염중호흡궤상관폐염환자적주요치병균。방법：선택55례환자분별재기관삽관혹절개궤계통기후적불동시간，즉：소우2 d、2 d후、발관전，분석심부지기관분비물세균배양여약민결과。결과：채집적129례표본중，유86례세균배양양성。공분리출세균112주，기중혁란음성간균점91.07%，이동록가단포균、포만불동간균、대장애희균、불동간균등위주，분별점39.28%、23.21%、7.14%、5.58%，위원내감염적주요치병균，구유다내약성급고내약솔。결론：유창궤계통기역인기하호흡도감염，도치의원획득성폐염혹호흡궤상관폐염。인차，감측치병균화급시약물민감시험，유리우림상항생소적선택급합리사용，종이강저원내감염화사망솔。
Objective:To observe the invasive mechanical ventilation major pathogens causing hospital-acquired pneumonia in patients with ventilator-associated pneumonia.Method:55 patients were intubated at a different time or cut after mechanical ventilation,ie:less than two days,two days later,before extubation,deep bronchial secretions bacterial culture and drug sensitivity were analysed.Result:A total of 129 cases collected specimens,there were 86 cases 112 were isolated from bacteria,of bacterial culture positive,including Gram-negative bacilli accounted for 91.07%,pseudomonas aeruginosa,acinetobacter baumannii,colon dilute egypt bacteria,acinetobacter,etc,accounting for 39.28%,23.21%,7.14%,5.58%separately.They were the main pathogens of nosocomial infections with multidrug resistance and high resistance rates.Conclusion:Invasive mechanical ventilation can lead to lower respiratory tract infection,which led to hospital-acquired pneumonia or ventilator-associated pneumonia in patients with severe illness. Therefore,the monitoring of pathogens and timely drug susceptibility testing in clinical is conducive to the rational use of antibiotics,so as to reduce nosocomial infections and mortality.
