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使用机械通气的 ICU 病人因其肺炎并发症率高达30～50%,以致其死亡率也至少在25%左右,因此降低肺部感染的发生率倍受关注。1978年 Atherton和 White 发现机械通气病人的胃和气管所繁殖的细菌相同,因而猜想患者胃内细菌的过度生长可能导致气道的继发感染。氏等建议口服非吸收性抗生素使胃肠道得到“消毒”,当可降低机械通气病人肺部感染的发生率。这一建议受到颇多作者的重视,并陆续有几组成效一致的报道。报道中提到的抗菌素因不同作者所面对的细菌菌种不同而各异,分别是多粘菌素、妥布霉素、两性霉素 B、制霉菌素、甲氧苄氨嘧啶、氨基糖甙类抗生素等,葡萄球菌为主者则用万古霉素。
ICU patients using mechanical ventilation due to their pneumonia complications rate as high as 30 to 50%, resulting in at least 25% mortality rate, thus reducing the incidence of pulmonary infection much concern. In 1978, Atherton and White found that patients with mechanically ventilated stomachs and trachea propagated the same bacteria, suggesting that overgrowth of bacteria in the patient’s stomach may result in secondary airway infections. Shi et al recommended oral non-absorbable antibiotics to gastrointestinal tract “disinfection”, which can reduce the incidence of pulmonary infection in patients with mechanical ventilation. This proposal has received the attention of quite a few authors and several group reports of consistent results. Antibiotics mentioned in the report vary according to the bacterial species different authors are facing, namely polymyxin, tobramycin, amphotericin B, nystatin, trimethoprim, aminosugar Glycosides such as antibiotics, Staphylococcus is the main use of vancomycin.