呼吸内科呼吸机相关肺炎发生的危险因素分析.docVIP

呼吸内科呼吸机相关肺炎发生的危险因素分析 　　[摘要] 目的 分析呼吸内科呼吸机相关肺炎（VAP）发生的危险因素。 方法 选择解放军第九四医院2008年8月～2013年6月使用呼吸机治疗的患者191例，分析并比较VAP在年龄、性别、呼吸机使用时间、慢性阻塞性肺疾病、气管切开情况、意识状态等因素间的分布情况；采用Logistic回归分析对VAP发生的危险因素进行分析。 结果 ①发生VAP的患者共17例，发生率为8.9%。②VAP发生率在年龄（≥60岁、 0.05）。③年龄≥60岁（OR =2.218）、呼吸机使用时间≥7 d（OR = 6.326）、合并慢性阻塞性肺疾病（OR = 5.575）与VAP发生相关（P 0.05）。 结论 呼吸机治疗时间、年龄、合并慢性阻塞性肺疾病等情况与VAP的发生密切相关，应针对上述危险因素进行预防防治。 　　[关键词] 呼吸机相关肺炎；护理；预防防治；危险因素 　　[中图分类号] R563.1 [文献标识码] A [文章编号] 1673-7210（2014）04（a）-0014-03 　　Risk factors analysis of occurrence of ventilator-associated pneumonia in patients with respiration medicine 　　WANG Peng XU Jinsong 　　Department of Pneumology， the 94th Hospital of China Peoples Liberation Army， Jiangxi Province， Nanchang 330002， China 　　[Abstract] Objective To analyze the risk factors of occurrence of ventilator-associated pneumonia （VAP） in patients with respiration medicine. Methods 191 patients with breathing machine treatment from August 2008 to June 2013 in the 94th Hospital of China Peoples Liberation Army were selected， the distributed situation of VAP in the elements of age， gender， breathing machine time， chronic obstructive pulmonary disease， conscious state， tracheotomy situation were analyzed and compared； Logistic analysis of regression was used to analyze the relative factors of VAP. Results ①17 patients with VAP were found and the occurrence rate was 8.9%. ②The difference of VAP occurrence rate in the elements of age （≥60 years， 0.05）. ③Age ≥60 years （OR = 2.218， P 0.05）， breathing machine time ≥7 d （OR = 6.326）， chronic obstructive pulmonary disease （OR = 5.575） were found had correlation with postoperative VAP according to the Logistic analysis of regression （P 0.05）. Conclusion Age， breathing machine time， chronic obstructive pulmonary disease are risk factors of VAP. It is right to take prevention to the risk factors. 　　[Key words] Ventilator-associated pneumonia； Nursing； Prevention； Risk factors 　　呼吸机相关肺炎（VAP）是指各种原因需要呼吸机支持的患者在接受呼吸机通气3 d后出现的呼吸道及肺组织的感染，属于