中国感染控制杂志2016，Vol.15Issue(11)：845-848,4.DOI:10.3969/j.issn.1671-9638.2016.11.010
呼吸机相关肺炎发病率及危险因素前瞻性研究
Prospective study on the incidence and risk factors of ventilator-associated pneumonia
摘要
Abstract
Objective To study the incidences and risk factors of ventilator-associated pneumonia (VAP ),and provide basis for prevention and control of VAP .Methods Patients who used ventilators in two tertiary first-class general hospitals from January 2006 to December 2011 were performed prospective monitoring;patients with VAP were selected as VAP group,and without VAP were in non-VAP group (1∶1 ratio),risk factors for VAP were analyzed.Results A total of 2 550 patients who used ventilators were monitored,475 cases of VAP occurred,the total number of ventilation days were 32 623,incidence rate of VAP was 14.56‰.Univariate analysis showed that risk factors for VAP were history of recurrent respiratory tract infection,use of broad spectrum antimicrobial agents within one month,multi-ple hospitalization,coma,hypoproteinemia,intubation again after failure in ventilator weaning,use of glucocorti-coid,mechanical ventilation for > 5 days,regurgitation,and poor oral hygiene.Multivariate logistic regression analysis showed that independent risk factors for the occurrence of VAP were coma (OR 95% CI :1 .38-2.93),hy-poproteinemia (OR 95% CI :1 .12-2.10),use of glucocorticoid (OR 95% CI :1 .10-2.24),intubation again after failure in ventilator weaning (OR 95% CI :2.14 -4.74),mechanical ventilation>5 days (OR 95% CI :2.55 -4.83),regurgitation (OR 95% CI :1 .24 - 2.77 ), and poor oral hygiene (OR 95% CI :1 .72 - 3.74 ). Conclusion Incidence of VAP is high,and risk factors are multiple,comprehensive intervention measures (proper oral hygiene,head-of-bed elevation,timely assessment of withdrawal of respirator,and improving nutritional sta-tus)should be taken,so as to reduce the incidence of VAP.关键词
呼吸机相关肺炎/危险因素/发病率/医院感染/病例对照/前瞻性研究Key words
ventilator-associated pneumonia/risk factor/incidence/healthcare-associated infection/case control/prospective study分类
医药卫生引用本文复制引用
黄妮妮,胡美春,韦思尊,黄霄,王秀葵,李勉,韦柳青..呼吸机相关肺炎发病率及危险因素前瞻性研究[J].中国感染控制杂志,2016,15(11):845-848,4.基金项目
广西医疗卫生自筹经费计划课题 （）
