【摘要】 目的通过回顾性分析呼吸机相关性肺炎(VAP)患者的临床资料和危险因素,提高对VAP的认识。方法收集2005年1月至2009年1月入住重症监护室行机械通气患者的临床资料,按诊断标准分为发生VAP组和未发生VAP组,对两组患者的临床特点、相关危险因素、病原菌分布和预后等进行比较分析。结果共收集138例,发生VAP组67例(48.6%),未发生VAP组71例(51.4%)。发生VAP组机械通气时间明显长于未发生VAP组(机械通气时间大于或等于10 d者,发生VAP组占82.1%,未发生VAP组占17.9%),深静脉穿刺留置导管的比例也高于未发生VAP组。发生VAP组共培养出病原菌216株,其中G-杆菌134株(62.04%),G+球菌34株(15.74%),真菌48株(22.22%),发生VAP组死亡23例,未发生VAP组死亡5例(P<0.05)。结论 VAP的发生可以显著提高病死率,应予重视。更多还原

【Abstract】 Objective To deepen the understanding about ventilator-associated pneumonia(VAP).Methods Patients admitted to the respiratory intensive care unit from Jan.2005 to Jan.2009 were divided into two groups,with or without VAP,according to the diagnosis criteria.The comparative analysis was performed in clinical characteristics,risk factors,distribution of pathological organisms and prognosis.Results The incidence of VAP was 48.6%(67/138 cases).The cases with deep venous catheter in VAP group were much more than non-VAP group(P<0.05).The duration of ventilation ≥10 days among the patients of VAP group was 82.1%,while it was 17.9% in non-VAP group.significantly higher than that of non-VAP group.216 microorganisms were detected from patients with VAP.Pathogenic bacteria of VAP in ICU were mostly multidrug-resistant ones.of which the G-were 62.04%,G+ were 15.74% and fungi were 22.22%.Conclusion The risk factors of VAP may be the use of deep venous catheter and long duration of ventilation.The main pathogens are Acinetobacter species,Pseudomonas aenbginosa,and yeasts.The presence of VAP can significantly increase the mortality of patients.Prevention of VAP is the priority of treatment for elderly patients.更多还原