某医院综合重症监护病房呼吸机相关肺炎的发病率及危险因素
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张秀月

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R181.3+2

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医院感染预防与控制能力建设项目(CHA-2012-XSPX-0629-1)


Incidence and risk factors for ventilatorassociated pneumonia in the intensive care unit of a hospital
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    摘要:

    目的分析某医院综合重症监护病房(ICU)呼吸机相关肺炎(VAP)发生的高危因素,为临床预防和控制VAP提供理论指导。方法采用目标性监测方法对2013年10月—2014年12月该医院ICU使用有创呼吸机>48 h的患者进行监测,分析其VAP发生的危险因素。结果监测期间共有483例患者接受呼吸机辅助呼吸且使用>48 h,其中76例发生VAP,VAP发病率为15.73%;使用呼吸机总日数为5 347 d,VAP发病率为14.21‰。单因素分析结果显示,性别、年龄、住院时间及人工气道留置时间各组比较,差异均有统计学意义,其中男性患者VAP发病率高于女性患者(χ2=9.838,P<0.01);年龄在41~70岁的患者VAP发病率最高(χ2=10.242,P<0.01),其次为≥71岁患者;住院时间越长的患者相应VAP发病率越高(χ2=59.533,P<0.01);人工气道留置时间越长的患者相应VAP发病率越高(χ2=74.215,P<0.01)。结论该医院ICU VAP发病率较高,且男性、年龄在41~70岁、住院时间长、人工气道留置时间长的患者VAP感染率更高。

    Abstract:

    ObjectiveTo analyze the risk factors for ventilatorassociated pneumonia(VAP) in the intensive care unit(ICU) of a hospital, and provide theoretical reference for preventing and controlling VAP.MethodsICU patients receiving mechanical ventilation for more than 48 hours between October 2013 and December 2014 were monitored by targeted monitoring method, risk factors for the occurrence of VAP were analyzed.ResultsA total of 483 patients received mechanical ventilation for more than 48 hours, 76 (15.73%) of whom developed VAP; the overall ventilator days were 5 347 days,incidence of VAP was 14.21 per 1 000 ventilator days. Univariate analysis showed that groups of gender, age, length of hospital stay, and duration of artificial airway were all significantly different, VAP rate in male patients was higher than that in female patients(χ2 =9.838,P<0.01);VAP rate was highest in patients aged 41-70 years(χ2 =10.242,P<0.01),followed by patients aged≥71 years; VAP rate were relatively higher in patients with longer length of hospital stay and longer duration of artificial airway(χ2 =59.533,P<0.01;χ2 =74.215,P<0.01, respectively).ConclusionIncidence of VAP in the ICU of this hospital is higher, especially in male patients, patients aged 41-70 years, as well as patients with long length of hospital stay and long duration of artificial airway.

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程莉莉,张秀月,杨洪艳.某医院综合重症监护病房呼吸机相关肺炎的发病率及危险因素[J]. 中国感染控制杂志,2017,16(1):70-72. DOI:10.3969/j. issn.1671-9638.2017.01.016.
CHENG Lili, ZHANG Xiuyue, YANG Hongyan. Incidence and risk factors for ventilatorassociated pneumonia in the intensive care unit of a hospital[J]. Chin J Infect Control, 2017,16(1):70-72. DOI:10.3969/j. issn.1671-9638.2017.01.016.

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  • 收稿日期:2016-08-07
  • 最后修改日期:2016-10-02
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  • 在线发布日期: 2017-01-22
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