【摘要】 目的探讨分析新生儿呼吸机相关性肺炎(VAP)的临床特点。方法收集2006年5月-2010年5月医院新生儿重症监护病房(NICU)行机械通气>48h的新生儿痰培养资料,对所有患儿的痰液标本进行病原菌菌种的分离及耐药性的分析。结果 82例在NICU行机械通气的患儿中,VAP患儿32例,发病率为39.02%;32例VAP患儿共分离出病原菌32株,其中革兰阴性杆菌占71.88%,且多为耐药,革兰阳性球菌占21.88%,真菌占6.24%;VAP患儿死亡率为15.62%,非VAP患儿死亡率仅为2.00%,VAP患儿的死亡率高于非VAP患儿,差异有统计学意义(P<0.05)。结论对于NICU机械通气患儿,认真分析痰培养中病原菌的结构,对于VAP的早期诊治具有一定作用。更多还原

【Abstract】 OBJECTIVE To explore the clinical characteristics of neonatal ventilator-associated pneumonia.METHODS 82 cases of sputum culture data were collected from May 2006 to May 2010 from these newborn babies who were admitted in hospital pediatric intensive care unit for mechanical ventilation more than 48 h.Pathogen isolation were performed for all fluid samples and the drug resistances were analyzed.RESULTS Among 82 cases of mechanical ventilation patients in the NICU,there were 32 cases of VAP,with the incidence rate of 39.02%.Of 32 VAP children,there were 23 gram-negative bacteria infection,accounting for 71.88%,and most of them were drug-resistant.Seven gram-positive cocci were isolated,accounting for 21.88%;2 fungi were observed,accounting for 6.25%.Meanwhile,27 of the 32 VAP children survived,and the mortality rate is 15.62%;only 1 of the 28 non-VAP patients died,with the mortality rate of 3.57%.VAP significantly increased mortality in children,there were significant differences(P<0.05).CONCLUSION Careful analysis of the pathogen population in sputum is important for the children with mechanical ventilation in NICU,which will also benefit to early diagnosis and treatment of VAP.更多还原