四川医学
四川醫學
사천의학
SICHUAN MEDICAL JOURNAL
2015年
4期
507-510
,共4页
新生儿%呼吸机相关性肺炎%相关因素
新生兒%呼吸機相關性肺炎%相關因素
신생인%호흡궤상관성폐염%상관인소
neonate%ventilator-associated pneumonia%related factors
目的：分析新生儿呼吸机相关性肺炎( ventilator-associated pneumonia,VAP)发病的相关危险因素,指导临床防治工作。方法回顾性研究本院新生儿科2012年全年收治机械通气时间≥48h的216例患者及病原学资料,使用检验和Logistic回归进行统计分析。结果单因素分析发现早产、低出生体重、机械通气时间、上机次数差异有统计学意义(P<0．05),而多因素分析发现机械通气时间和上机次数与VAP发病相关。结论早产低体重儿免疫系统发育不成熟,易发生感染。气管插管将外界及口咽部细菌下移,气管导管停留时间越长,其表面细菌定殖越多,并以多重耐药菌为主。临床防治VAP提倡从患者管理、呼吸机管理、病房管理及人员管理各方面加强的集束化管理。
目的：分析新生兒呼吸機相關性肺炎( ventilator-associated pneumonia,VAP)髮病的相關危險因素,指導臨床防治工作。方法迴顧性研究本院新生兒科2012年全年收治機械通氣時間≥48h的216例患者及病原學資料,使用檢驗和Logistic迴歸進行統計分析。結果單因素分析髮現早產、低齣生體重、機械通氣時間、上機次數差異有統計學意義(P<0．05),而多因素分析髮現機械通氣時間和上機次數與VAP髮病相關。結論早產低體重兒免疫繫統髮育不成熟,易髮生感染。氣管插管將外界及口嚥部細菌下移,氣管導管停留時間越長,其錶麵細菌定殖越多,併以多重耐藥菌為主。臨床防治VAP提倡從患者管理、呼吸機管理、病房管理及人員管理各方麵加彊的集束化管理。
목적：분석신생인호흡궤상관성폐염( ventilator-associated pneumonia,VAP)발병적상관위험인소,지도림상방치공작。방법회고성연구본원신생인과2012년전년수치궤계통기시간≥48h적216례환자급병원학자료,사용검험화Logistic회귀진행통계분석。결과단인소분석발현조산、저출생체중、궤계통기시간、상궤차수차이유통계학의의(P<0．05),이다인소분석발현궤계통기시간화상궤차수여VAP발병상관。결론조산저체중인면역계통발육불성숙,역발생감염。기관삽관장외계급구인부세균하이,기관도관정류시간월장,기표면세균정식월다,병이다중내약균위주。림상방치VAP제창종환자관리、호흡궤관리、병방관리급인원관리각방면가강적집속화관리。
Objective Analyze the related factors of neonatal ventilator-associated pneumonia(VAP),and provide help for clinical prevention and control. Methods A retrospective study was conducted on 216 patients with mechanical ventilation treatment over 48 hours who were admitted to NICU in our hospital at 2012. The data was collected from medical records and sub-mitted to statistical analysis by using test and logistic regression. Results Our data revealed that premature birth, low birth weight ,duration of mechanical ventilation and the number of mechanical ventilation were statistically significant in univariate analy-sis. However,duration of mechanical ventilation and the number of mechanical ventilation times were statistically significant in mul-tivariable analysis. Conclusion The results indicated that premature children had a higher risk of infection incidence because of the immature neonatal immune system. The endotracheal tube could facilitate bacterial from the outside and oropharyngeal entry in-to the lower respiratory tract and tracheal colonization. The surface bacterial colonization is increased with longer residence time of the endotracheal tube. Moreover,the bacteria are mainly multidrug-resistant. Therefore,our results suggested that clinical prevention should advocate cluster management,which were consisted of strengthen patient management,ventilator management,ward manage-ment,and personnel management.
