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目的:探讨真菌致呼吸机相关性肺炎的危险因素。方法:回顾性分析本院RICU和ICU2009年至2012年呼吸机相关性肺炎患者98例的临床资料,分为真菌性呼吸机相关性肺炎(FVAP)组和非真菌性呼吸机相关性肺炎(NFVAP)组,比较两组真菌感染的易患因素,采用单因素(X2检验)及多因素Logistic回归进行统计学分析。结果:急性生理学及慢性健康状况评分(APACHEⅡ)、使用MV时间(>7d)、住院时间(>15d)、血白蛋白<25 g、合并糖尿病、联合使用抗生素、频繁更换抗生素(>2次/周)是导致真菌性呼吸机相关性肺炎的危险因素,其中血白蛋白<25 g、联合使用抗生素、频繁更换抗生素(>2次/周)是导致真菌性呼吸机相关性肺炎的独立危险因素。结论:患者血白蛋白<25 g、联合使用抗生素、频繁更换抗生素(>2次/周)是导致真菌性呼吸机相关性肺炎的独立危险因素。
Objective: To investigate the risk factors of ventilator-associated pneumonia caused by fungi. Methods: The clinical data of 98 patients with ventilator-associated pneumonia in the RICU and ICU from 2009 to 2012 in our hospital were retrospectively analyzed. They were divided into three groups: Fungal ventilator-associated pneumonia (FVAP) group and non-ventilator-associated pneumonia ) Group. The susceptible factors of fungal infection in the two groups were compared. The single factor (X2 test) and multivariate Logistic regression were used for statistical analysis. Results: Acute physiology and chronic health status score (APACHEⅡ), the use of MV time (> 7d), hospital stay (> 15d), serum albumin <25g, diabetes mellitus, combined antibiotics, frequent antibiotics replacement Week) are risk factors for fungal ventilator-associated pneumonia with albumin <25 g, combined antibiotics, frequent antibiotic changes (> 2 times / week) are independent risk factors for fungal ventilator-associated pneumonia . CONCLUSIONS: Patients with serum albumin <25 g, combined with antibiotics, and frequent antibiotic changes (> 2 bouts per week) are independent risk factors for fungal ventilator-associated pneumonia.