解放军医学院学报2016，Vol.37Issue(12)：1248-1251,4.DOI:10.3969/j.issn.2095-5227.2016.12.008
高龄患者呼吸机相关性肺炎病原菌分布及不同气管置管方式影响因素分析
Analysis of risk factors and pathogen distribution of ventilator-associated pneumonia with different endotracheal intubation access in elderly patients
摘要
Abstract
Objective To analyze the risk factors and the distribution of pathogenic bacteria of ventilator-associated Pneumonia (VAP) with different endotracheal intubation access in elderly patients,in order to provide evidences for prevention and therapy of VAP.Methods Clinical data about aged patients (80 years or over) who had received mechanical ventilation over 48 hours from January 2011 to December 2015 in Chinese PLA General Hospital were retrospectively anayzed.Results Totally 390 cases were included in this study.Of the 240 patients underwent tracheal intubation,39 cases were diagnosed as VAP with the incidence of 16.25％;Of the 150 patients underwent tracheotomy,34 patients had VAP with the incidence of 22.67％.Gram-negative bacteria were the major pathogens in elderly patients with different mechanical ventilation access,and the preceding three were Pseudomonas aeruginosa,Acinetobacter baumannii,Stenotrophomonas maltophilia.Logistic regression analysis showed that the risk factors of VAP for elderly patients with tracheal intubation were COPD (OR=0.234,95％ CI=0.058-0.936,P=0.040),duration of mechanical ventilation (OR=5.258,95％ CI=2.037-13.572,P=0.001),the use of hormone (OR=3.047,95％ CI=1.391-6.673,P=0.005).Number of combined application of antibacterials was negatively related to the occurrence of VAP for elderly patients with tracheotomy (OR=0.101,95％ CI=0.013-0.783,P=0.028).Conclusion Gram-negative bacteria were the most common pathogens of VAP.Risk factors of ventilator-associated pneumonia with different mechanical ventilation access are different.关键词
肺炎,呼吸机相关性/老年人,80以上/病原菌Key words
pneumonia, ventilator-associated/aged, 80 and over/pathogen分类
医药卫生引用本文复制引用
徐月,侯惠如,杨晶,来纯云,耿玲,刘英..高龄患者呼吸机相关性肺炎病原菌分布及不同气管置管方式影响因素分析[J].解放军医学院学报,2016,37(12):1248-1251,4.基金项目
部委级资助项目 （）
总后勤部卫生部保健专项科研课题(14BJZ05)Supported by the Health Care Project of Health Ministry of General Logistic Department of PLA(14BJZ05) （14BJZ05）
