EM202胃液细菌定植与重症脑出血患者呼吸机相关肺炎的关系研究.pdfVIP

胃液细菌定植与重症脑出血患者呼吸机相关肺炎的关系研究 杨志洲 林金锋 邵旦兵 刘红梅 任艺 张炜 唐文杰 许宝华 聂时南* (南京军区南京总医院急救医学科，南京210002) [摘要] 目的: 研究重症脑出血机械通气患者胃内细菌定植在呼吸机相关性肺炎（ventilator associated pneumonia，VAP ）发病中的作用。 方法: 对2011 年1 月至2013 年1 月入住我院急诊重症监护病房（emergency intensive care unit, EICU）的重症脑出血机械通气患者进行胃液、口咽及下呼吸道标本的细菌培养，分析这三类 标本的细菌种类是否存在一致性，同时检测胃液的pH 值。 结果:重症脑出血机械通气患者胃液、口咽及下呼吸道的标本细菌种类存在一致性，且定值 组胃液pH 值显著高于非定值组，差异具有统计学意义（P 值＜0.001 ）。 结论:与胃液pH 值升高相关的胃内细菌定植是重症脑出血机械通气患者VAP 病原菌的重要来 源。 [关键词] 脑出血，呼吸机相关肺炎，胃液，病原菌定植 The relationship between intragastric bacteria colonization and the incidence of VAP in patients with serious cerebral hemorrhage YANG Zhizhou, LIN Jinfeng, S HAO Danbing, LIU Hongmei, REN Yi, ZHANG Wei, TANG Wenjie, X U * Baohua, NIE Shinan , Emergency Department，Nanjing General Hospital of Nanjing Military Command, Nanjing 210002, China. [Abstract] Objective: To investigate the role of intragastric bacteria colonization in the pathogenesis of ventilator associated pneumonia(VAP) in serious cerebral hemorrhage undergoing mechanical ventilation. Methods: Bacteriological examination was made for the samples of gastric fluid, lower respiratory tract and pharyngeal swab of sixty-two serious cerebral hemorrhage undergoing mechanical ventilation patients admitted to our Emergency Intensive Care Unit(EICU) *通信作者：聂时南，主任医师,教授，科主任。 基金项目：1、南京军区重大专项课题 （编号12Z32）。 2、南京军区南京总医院科研课题(编号2013023)。 from January 2011 to January 2013. To analyse consistency of the three kinds of samples. At the same time, measure pH value of gastric fluid. Results: There is homogeneity among the samples of gastric fluid, lower respiratory tract and pharyngeal swab of serious cerebral hemorrhage undergoing mechanical ventilation patients(P value ＜0.001). Patients with intragastric bacteria colonization have a higher pH value than patients without it (P v