河北医学
河北醫學
하북의학
HEBEI MEDICINE
2015年
11期
1885-1888
,共4页
护理干预%呼吸机相关性肺炎%重症监护室%独立危险因素
護理榦預%呼吸機相關性肺炎%重癥鑑護室%獨立危險因素
호리간예%호흡궤상관성폐염%중증감호실%독립위험인소
Nursing intervention%Ventilator-associated pneumonia%Intensive care unit%Inde-pendent risk factor
目的：探讨重症监护室患者呼吸机相关性肺炎（ VAP ）的独立危险因素，寻找相应的护理干预措施。方法：回顾性分析重症监护室120例机械通气患者的临床资料，根据发生VAP 与否分组，先行单因素分析筛选出有统计学意义的变量，再行Logistic回归逐步分析确定VAP 的独立危险因素，制定相应的护理措施。结果：发生VAP 与未发生VAP的患者单因素分析显示在插管方式、抑酸剂、机械通气时间、入住重症监护室时间、镇静评分、昏迷评分、使用激素和应用呼吸机前48h使用抗菌药物等比较，差异有统计学意义（ P＜0．05）。多因素分析只有抑酸剂、机械通气时间、昏迷评分及应用呼吸机前48h使用抗菌药物是重症监护室VAP发生的独立危险因素（ OR值分别为4．674、2．681、7．542和3．690）。结论：通过对重症监护室VAP 独立危险因素的分析，有利于制定科学的护理干预措施，为降低VAP的发生率奠定基础。
目的：探討重癥鑑護室患者呼吸機相關性肺炎（ VAP ）的獨立危險因素，尋找相應的護理榦預措施。方法：迴顧性分析重癥鑑護室120例機械通氣患者的臨床資料，根據髮生VAP 與否分組，先行單因素分析篩選齣有統計學意義的變量，再行Logistic迴歸逐步分析確定VAP 的獨立危險因素，製定相應的護理措施。結果：髮生VAP 與未髮生VAP的患者單因素分析顯示在插管方式、抑痠劑、機械通氣時間、入住重癥鑑護室時間、鎮靜評分、昏迷評分、使用激素和應用呼吸機前48h使用抗菌藥物等比較，差異有統計學意義（ P＜0．05）。多因素分析隻有抑痠劑、機械通氣時間、昏迷評分及應用呼吸機前48h使用抗菌藥物是重癥鑑護室VAP髮生的獨立危險因素（ OR值分彆為4．674、2．681、7．542和3．690）。結論：通過對重癥鑑護室VAP 獨立危險因素的分析，有利于製定科學的護理榦預措施，為降低VAP的髮生率奠定基礎。
목적：탐토중증감호실환자호흡궤상관성폐염（ VAP ）적독립위험인소，심조상응적호리간예조시。방법：회고성분석중증감호실120례궤계통기환자적림상자료，근거발생VAP 여부분조，선행단인소분석사선출유통계학의의적변량，재행Logistic회귀축보분석학정VAP 적독립위험인소，제정상응적호리조시。결과：발생VAP 여미발생VAP적환자단인소분석현시재삽관방식、억산제、궤계통기시간、입주중증감호실시간、진정평분、혼미평분、사용격소화응용호흡궤전48h사용항균약물등비교，차이유통계학의의（ P＜0．05）。다인소분석지유억산제、궤계통기시간、혼미평분급응용호흡궤전48h사용항균약물시중증감호실VAP발생적독립위험인소（ OR치분별위4．674、2．681、7．542화3．690）。결론：통과대중증감호실VAP 독립위험인소적분석，유리우제정과학적호리간예조시，위강저VAP적발생솔전정기출。
Objective: To investigate the independent risk factors of ventilator -associated pneumonia( VAP ) in patients of intensive care units ( ICU ) , and to search for corresponding nursing interventions . Method:The clinical data of 120 patients with mechanical ventilation of ICU were retrospectively analyzed . The patients were assiqned according to whether they suffered from VAP or not .Statistically significant varia-bles were screened by single factor analysis , and then Logistic regression analysis was conducted to confirm the independent risk factors of VAP .Corresponding nursing interventions were consequently formulated .Re-sult:The single factor analysis of patients with VAP and without VAP revealed that the differences in intuba-tion way, acid inhibitor, time of mechanical ventilation , length of stay in ICU, sedation and coma scores , use of hormones, and use of antibacterials at 48h before use of a ventilator were statistically significant (P<0.05).And multiplicity revealed that only acid inhibitor , time of mechanical ventilation , coma score, and use of antibacterials at 48h before use of a ventilator were independent risk factors of VAP in ICU ( the OR values were 4.674, 2.681, 7.542, and 3.690, respectively).Conclusion:Analysis on independent risk fac-tors of VAP in ICU is beneficial to formulating scientific nursing interventions , and establishes the foundation for decreasing the incidence of VAP .
