现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2015年
9期
1298-1299,1304
,共3页
肺炎,呼吸机相关性%通气机,机械%危险因素%预后%儿童
肺炎,呼吸機相關性%通氣機,機械%危險因素%預後%兒童
폐염,호흡궤상관성%통기궤,궤계%위험인소%예후%인동
Pneumonia,ventilator-associated%Ventilators,mechanical%Risk factors%Prognosis%Child
目的：探讨小儿呼吸机相关性肺炎（VAP）的相关危险因素，为临床诊断、治疗及预后评估提供依据。方法选择2008年1月至2012年6月该院收治的248例行机械通气患儿的临床资料，将发生VAP的68例患儿作为VAP组，未发生VAP的180例患儿作为非VAP组，分别对两组患儿相关危险因素进行单因素分析，将有显著相关性的危险因素纳入logistic回归模型做进一步分析。结果单因素分析显示，营养状态、营养支持方式、降钙素原水平、痰量分度、合并原发性肺部疾病、昏迷、机械通气时间、激素使用8个危险因素与VAP发生存在明显相关性；logistic回归分析提示，降钙素原水平、机械通气时间、痰量分度、激素使用4个危险因素与VAP发生存在明显相关性。结论对于降钙素原水平明显升高、机械通气时间长、痰多痰稠、排痰不畅、使用激素的患儿，应尽早给予相应处理，以降低小儿VAP发生率及病死率，改善预后。
目的：探討小兒呼吸機相關性肺炎（VAP）的相關危險因素，為臨床診斷、治療及預後評估提供依據。方法選擇2008年1月至2012年6月該院收治的248例行機械通氣患兒的臨床資料，將髮生VAP的68例患兒作為VAP組，未髮生VAP的180例患兒作為非VAP組，分彆對兩組患兒相關危險因素進行單因素分析，將有顯著相關性的危險因素納入logistic迴歸模型做進一步分析。結果單因素分析顯示，營養狀態、營養支持方式、降鈣素原水平、痰量分度、閤併原髮性肺部疾病、昏迷、機械通氣時間、激素使用8箇危險因素與VAP髮生存在明顯相關性；logistic迴歸分析提示，降鈣素原水平、機械通氣時間、痰量分度、激素使用4箇危險因素與VAP髮生存在明顯相關性。結論對于降鈣素原水平明顯升高、機械通氣時間長、痰多痰稠、排痰不暢、使用激素的患兒，應儘早給予相應處理，以降低小兒VAP髮生率及病死率，改善預後。
목적：탐토소인호흡궤상관성폐염（VAP）적상관위험인소，위림상진단、치료급예후평고제공의거。방법선택2008년1월지2012년6월해원수치적248례행궤계통기환인적림상자료，장발생VAP적68례환인작위VAP조，미발생VAP적180례환인작위비VAP조，분별대량조환인상관위험인소진행단인소분석，장유현저상관성적위험인소납입logistic회귀모형주진일보분석。결과단인소분석현시，영양상태、영양지지방식、강개소원수평、담량분도、합병원발성폐부질병、혼미、궤계통기시간、격소사용8개위험인소여VAP발생존재명현상관성；logistic회귀분석제시，강개소원수평、궤계통기시간、담량분도、격소사용4개위험인소여VAP발생존재명현상관성。결론대우강개소원수평명현승고、궤계통기시간장、담다담주、배담불창、사용격소적환인，응진조급여상응처리，이강저소인VAP발생솔급병사솔，개선예후。
Objective To explore the risk factors of ventilator associated pneumonia (VAP) in children related to me-chanical ventilation,providing the valuable data for clinical diagnosis,treatment and prognosis. Methods The clinical data from 248 children patients undergoing mechanical ventilationfrom January 2008 to June 2012 in this hospital were divided into VAP-group(68 cases) and non-VAP group(180 cases),whose risk factors in the two groups were conducted single factor analysis. And the significant risk factors were considered into logistic regressive model analysis. Results The single factor analysis showed that nutrition condition,nutrition supporting method,procalciton in level,sputum scale,complicated primary lung diseases,coma,me-chanical ventilation time,glucocorticoids application were significantly associated,and it also demonstrated that the four risk fac-tors such asprocalcitonin level,sputumscale,mechanical ventilation time,glucocorticoids application were closely correlated to ventilator associated pneumonia. Conclusion For those with procalciton in level increased distinctively ,long mechanical ventila-tion time,much sputumand hardly elimination of sputum,glucocorticoids application,it should be given correspondent treatment to reduce the morbidity and mortality of ventilator associated pneumonia in child renpatients and improve prognosis conditions.
