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[目的]探讨重症监护病房(ICU)呼吸机相关性肺炎(VAP)的危险因素、病原菌特点,为防控措施提供依据。[方法]对ICU2008年7月～2009年6月419例接受机械通气治疗的患者采取前瞻性调查。结果VAP发生率18.62%;侵入性操作的使用,机械通气时间﹥5d,年龄﹥65岁,均为VAP发生的危险因素;VAP患者分离到的病原菌以革兰阴性菌为主,占69.90%,革兰阳性菌(25.81%)和真菌(4.30%)。[结论]ICU机械通气患者VAP发生率高,由多种高危因素引起,加强病区环境管理、严格执行无菌技术操作及手卫生规范、缩短机械通气时间、合理使用抗菌药物等措施才能有效降低VAP发生。
[Objective] To explore the risk factors and pathogens of ventilator-associated pneumonia (VAP) in intensive care unit (ICU) and provide basis for prevention and control measures. [Methods] A prospective investigation was performed on 419 ICU patients undergoing ICU between July 2008 and June 2009 in ICU. Results The incidence of VAP was 18.62%. The use of invasive procedure, mechanical ventilation time> 5 days and age> 65 years were the risk factors of VAP. Gram-negative bacteria were the main pathogens in VAP patients, accounting for 69.90% Gram-positive bacteria (25.81%) and fungi (4.30%). [Conclusion] The incidence of VAP in ICU patients with mechanical ventilation is high, which is caused by a variety of risk factors. Enhancing environmental management in the ward, strictly implementing aseptic technique and hand hygiene regulations, shortening the duration of mechanical ventilation and rational use of antimicrobial agents can effectively reduce VAP happened.