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目的探讨儿科重症监护病房(PICU)呼吸机相关性肺炎(VAP)的发生率及危险因素。方法对某中心PICU 2011年1月-2012年12月行机械通气>48 h的180例患儿进行目标性监测,按照是否合并VAP分为VAP组和非VAP组,对2组进行单因素检验及多因素Logistic回归分析。结果 180例患儿中发生VAP 24例,发生率为13.3%。单因素检验显示VAP组与非VAP组比较,更易合并基础疾病、营养不良,且气管插管时间较长(P均<0.05),而多因素非条件Logistic回归分析显示营养不良(OR=3.048,P=0.034)、气管插管时间较长(OR=9.281,P=0.004)为VAP发生的独立危险因素(P均<0.05)。结论 PICU机械通气患儿发生VAP概率较高,营养不良、气管插管时间较长均为VAP发生的独立危险因素,应针对上述危险因素实施相应的对策以减少VAP的发生。
Objective To investigate the incidence and risk factors of ventilator associated pneumonia (PAP) in pediatric intensive care unit (PICU). Methods A total of 180 children undergoing mechanical ventilation for> 48 hours from January 2011 to December 2012 in a PICU were enrolled in the study. According to whether VAP was divided into VAP group and non-VAP group, single-factor test And multivariate logistic regression analysis. Results VAP occurred in 180 cases in 24 cases, the incidence was 13.3%. Univariate tests showed that VAP group was more likely to have underlying diseases, malnutrition, and intubation longer (P <0.05), while multivariate non-conditional logistic regression analysis showed malnutrition (OR = 3.048, P = 0.034). The longer intubation time (OR = 9.281, P = 0.004) was an independent risk factor for VAP (all P <0.05). Conclusion The incidence of VAP in PICU patients with mechanical ventilation is higher, malnutrition and intubation time are independent risk factors of VAP. Corresponding countermeasures should be taken to reduce the incidence of VAP.