ICU应用有创呼吸机患者发生下呼吸道感染危险因素分析.docVIP

ICU应用有创呼吸机患者发生下呼吸道感染危险因素分析 　　[摘要] 目的 分析ICU应用有创呼吸机患者发生下呼吸道感染的危险因素。 方法 回顾性分析2014年1月～2016年12月我院ICU应用有创呼吸机发生下呼吸道感染100例患者的临床资料，选取影响下呼吸道感染相关因素进行Logistic回归分析。 结果 100例应用有创呼吸机患者中，有32例患者发生了下呼吸道感染疾病，概率在32.0%，有11例因医治无效而死亡，死亡率在34.4%；单因素分析显示白蛋白水平、APACHEII评分、呼吸机应用时间、胃内容物返流、体位、应用抗酸剂、糖皮质激素、其他侵入性操作因素为术后肺部感染的相关因素，差异有统计学意义（P0.05）；APACHE 11评分、呼吸机应用时间、胃内容物返流和平卧位为引起有创呼吸机的患者发生下呼吸道感染的独立危险因素。 结论 ICU应用有创呼吸机的患者发生下呼吸道感染与多种因素有关，采取综合治疗措施有助于下呼吸道感染的预防与控制。 　　[关键词] 重症病房；有创呼吸机；下呼吸道感染；危险因素 　　[中图分类号] R56 [文献标识码] A [文章编号] 2095-0616（2017）08-225-03 　　[Abstract] Objective To analyze the risk factors of lower respiratory tract infection in ICU patients with invasive ventilator. Methods Retrospective analysis of clinical data of 100 patients with lower respiratory tract infection from January，2014 to December 2016 in ICU of our hospital.Logistic regression analysis was carried out to investigate the influencing factors of lower respiratory tract infection. Results 100 patients with invasive ventilator，32 patients had lower respiratory tract infection with a probability of 32.0%.Eleven patients died due to ineffective treatment and the mortality rate was 34.4%.Univariate analysis showed that albumin level （P0.05），APACHEI score，time of ventilator application，gastric contents reflux，posture， application of antacids，glucocorticoids，other invasive factors were postoperative pulmonary infection （P0.05），Ventilator application time，gastric contents regurgitation and supine position were independent risk factors for lower respiratory tract infection in patients with invasive ventilators. Conclusion The occurrence of lower respiratory tract infection in patients with invasive ventilator is related to many factors.Comprehensive treatment measures are helpful for the prevention and control of lower respiratory tract infection. 　　[Key words] Intensive wards；Invasive ventilator；Lower respiratory tract infection；Risk factors 　　随着医学的发展，对于医疗质量的要求越来越高，而医院感染已经成为医院发展和提高医疗质量的重大障碍。NICU收治患者多为严重神经系统受损疾病患者，常具有基础疾病多、起病急、病情危重，常伴