【摘要】 目的探讨老年患者呼吸机相关性肺炎(VAP)的危险因素以及病原菌分布情况,为预防VAP发生及治疗提供依据。方法回顾性分析我院ICU收治的机械通气时间>48h的78例老年患者的临床资料,并将患者分为VAP组和非VAP组。结果 VAP组患者ICU住院时间、机械通气时间均长于非VAP组,再次行气管插管、使用抑酸剂、发生胃食道反流及误吸患者的比例均显著高于非VAP组,差异均有统计学意义(P<0.05)。45例VAP患者共检出病原菌59株,其中革兰阴性菌41株,占69.5%,明显高于革兰阳性菌(14株,23.7%)及真菌(4株,6.8%)。结论患者ICU住院时间、机械通气时间以及再次行气管插管、使用抑酸剂、发生胃食道反流及误吸是老年患者发生VAP的危险因素;老年患者VAP感染的病原菌以革兰阴性菌为主。更多还原

【Abstract】 Objective To investigate the risk factors of ventilator-associated pneumonia( VAP) in elderly patients and the distribution condition of pathogens,and to provide evidence for the prevention and treatment of VAP.Methods The clinical data of78 elderly patients with mechanical ventilation time of over 48 hours in ICU of our hospital were retrospectively analyzed,and the patients were divided into VAP group and non-VAP group.Results The ICU hospitalization time and mechanical ventilation time of patients in VAP group were all longer than those in non-VAP group.The ratios of patients with tracheal intubation again,use of acid suppression agent,and gastroesophageal reflux and aspiration in VAP group wereall higher than those in non-VAP group,and the difference was statistically significant( P<0. 05).59 strains of pathogenic bacteria were detected in all of the 45 cases of patients with VAP,of which the gram negative bacteria were 41 strains,accounting for 69. 5%,significantly higher than the gram positive bacteria( 14 strains,23. 7%) and fungi( 4 strains,6. 8%).Conclusion The ICU hospitalization time,mechanical ventilation time,re tracheal intubation,the use of acid suppression agent,and gastroesophageal reflux and aspiration of patients are risk factors for VAP in elderly patients.更多还原