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目的:研究关于呼吸机相关性肺炎的病原学、发病机制、诊断及治疗等,以便减少该病的发生率,提高治愈率。方法:收集本院重症医学科2012年1月~2013年12月机械通气患者136例,其中发生VAP例数为51。结果:本组VAP的发生率为41.78%,病死率36.07%。共检出病原菌89株,其中G-杆菌71.92%、G+菌11.23%、真菌16.85%。非VAP组病死率17%。结论:VAP的主要致病茵为G-杆菌;G+菌、真菌感染比例也逐渐增加,临床上合理应用抗生素,积极治疗原发病,缩短上机时间、避免医源性危险因素,加强免疫治疗,可以降低呼吸机相关性肺炎的发生。
Objective: To study the etiology, pathogenesis, diagnosis and treatment of ventilator-associated pneumonia in order to reduce the incidence of the disease and improve the cure rate. Methods: 136 patients with mechanical ventilation were collected from January 2012 to December 2013 in our department of critical care. Among them, the number of VAP cases was 51. Results: The incidence of VAP in this group was 41.78% and the case fatality rate was 36.07%. A total of 89 pathogens were detected, of which 71.92% of G-bacteria, 11.23% of G + bacteria and 16.85% of fungi. Non-VAP group mortality rate of 17%. Conclusion: The main pathogen of VAP is G-bacilli. The proportion of G + bacteria and fungi infection also increases gradually. The rational use of antibiotics clinically, the active treatment of the primary disease, shortening the time on the machine, avoiding the iatrogenic risk factors and strengthening the immunotherapy , Can reduce the occurrence of ventilator-associated pneumonia.