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目的:研究机械通气患者发生呼吸机相关性肺炎(VAP)的危险因素。方法:回顾性分析2011-05-2013-05我院重症监护病房使用有创机械通气治疗的176例患者临床资料,对年龄、性别、血清白蛋白水平、营养方式、机械通气时间、APACHEⅡ评分、再次插管、气管切开、使用糖皮质激素、静脉使用镇静剂、置入中心静脉导管和使用质子泵抑制剂进行单因素分析,并对有统计学意义的因素进行Logistic多因素回归分析,探讨呼吸机相关性肺炎发生的危险因素。结果:气管切开、血清白蛋白≤30g/L、机械通气时间≥7d,APACHEⅡ评分≥20分,使用质子泵抑制剂是VAP发生的独立危险因素。结论:机械通气患者应加强营养,尽量避免气管切开,尽早脱机,尽量不使用质子泵抑制剂,减少呼吸机相关性肺炎的发生。
Objective: To study the risk factors of ventilator-associated pneumonia (VAP) in patients with mechanical ventilation. Methods: Retrospective analysis of the clinical data of 176 patients treated with invasive mechanical ventilation in intensive care unit of our hospital from May 2011 to May 2013, age, gender, level of serum albumin, nutrition, duration of mechanical ventilation, APACHEⅡscore, Re-intubation, tracheotomy, glucocorticoid, intravenous sedation, central venous catheterization and proton pump inhibitor univariate analysis, and statistically significant factors Logistic multivariate regression analysis to explore the respiration Risk factors for the development of machine-related pneumonia. Results: Tracheotomy, serum albumin ≤ 30g / L, mechanical ventilation ≥ 7d, APACHE Ⅱ score ≥ 20 points, the use of proton pump inhibitor is an independent risk factor for VAP. Conclusion: Patients with mechanical ventilation should strengthen nutrition, try to avoid tracheotomy, as soon as possible offline, try not to use proton pump inhibitors to reduce the occurrence of ventilator-associated pneumonia.