重症监护病房呼吸机相关性肺炎的危险因素分析及护理.docVIP

重症监护病房呼吸机相关性肺炎的危险因素分析及护理 　　[摘要] 目的 探讨重症监护病房呼吸机相关性肺炎的危险因素分析及护理。 方法 选择2011年1月～2013年1月在我院重症监护病房行机械通气的患者216例，其中发生VAP共50例，对VAP的发生进行相关单因素分析及采用Logistic回归分析探讨VAP发生的危险因素。 结果 年龄、意识状态、机械通气时间、实施气管切开与否、抗生素的联合应用种类及基础疾病与VAP的发生密切相关，差异有统计学意义（P 0.05）。Logistic回归分析结果显示，年龄≥60岁、合并基础疾病、气管切开、机械通气时间≥3 d及意识障碍、抗生素联合应用≥2种为重症监护病房行机械通气患者发生VAP的危险因素。 结论 重症监护病房进行机械通气的患者发生呼吸机相关性肺炎的影响因素较多，采取有效的护理干预措施是预防VAP发生的重要途径，可有效降低VAP的发生率。 　　[关键词] 呼吸机相关性肺炎；危险因素；重症监护病房；护理 　　[中图分类号] R473.5 [文献标识码] B [文章编号] 1673-9701（2013）25-0087-03 　　ICU ventilator-associated pneumonia risk factors and nursing 　　ZHAN Meihong XU Lingfen 　　Huzhou City Central Hospital，Huzhou 313000， China 　　[Abstract] Objective To investigate the ICU ventilator associated pneumonia risk factors and treatments. Methods from January 2011 to January 2013 in our hospital ICU mechanical ventilation in patients with 216 cases， of which a total of 50 cases of VAP occurred on the incidence of VAP and the related univariate analysis using logistic regression analysis of VAP risk factors. Results The age，state of consciousness，duration of mechanical ventilation， tracheostomy or not implemented，the combined application of antibiotics types and underlying diseases were closely related with the incidence of VAP， the difference was statistically significant（P 0.05）. Logistic regression analysis showed that age ≥60 years，underlying diseases，tracheostomy，mechanical ventilation ≥3 days and unconsciousness， antibiotics in combination ≥2 species of mechanical ventilation in ICU patients with risk factors for VAP. Conclusion ICU patients with mechanical ventilation ventilator-associated pneumonia influenced by many factors，to take effective nursing interventions are an important way to prevent the occurrence of VAP，which can effectively reduce the incidence of VAP. 　　[Key words] Ventilator-associated pneumonia； Risk factors； ICU； Care 　　呼吸机相关性肺炎（VAP）是指患者接受机械通气治疗48 h后和停用机械通气、拔出人工气道48 h内发生的肺实质性炎症[1]。了解VAP发生的危险因素，并提出相应的对策，可以显著提高重症患者抢救的成功率并缩短机械通气时间，对防治VAP的发生有