广州医药2024，Vol.55Issue(2)：116-120,5.DOI:10.3969/j.issn.1000-8535.2024.02.002
机械通气患者呼吸机相关性肺炎的病例对照研究
Mechanical ventilation patients with ventilator-associated pneumonia:a case-control study
摘要
Abstract
Objective To explore the risk factors of ventilator-associated pneumonia(VAP)in patients with mechanical ventilation,and provide a reference basis for medical institutions to reduce the occurrence of VAP.Methods A retrospective case-control method was used to collect data of patients who hospitalized in intensive care unit(ICU)from January 2020 to April 2021,received mechanical ventilation＞48 h and were＞18 years old.According to the diagnostic criteria,20 patients with VAP infection were enrolled as the case group.During the same period,20 non-infected patients who matched sex,age with case group patients were enrolled as the control group,and the clinical indicators between the two groups were statistically analyzed.Results There were no significant differences between the two groups in terms of admission diagnosis,surgery and chronic obstructive pulmonary disease,APACHEII score and place of intubation before mechanical ventilation(P＞0.05).There were no significant differences in white blood cell,C-reactive protein and procalctionin,CRP and PCT during the mechanical ventilation period(P＞0.05).Compared with the control group,the length of stay in hospital,the length of stay in ICU,the time of mechanical ventilation,number of sputum suction nursing,and the days of antibiotic use increased significantly(all P＜0.05).Among them,Acinetobacter baumannii resistant to carbapenem in ICU(accounting for 70%)was the main cause of VAP infection.The environmental hygiene monitoring found that Acinetobacter baumannii was detected in the patient's surrounding environment,the nurse station and the disinfected items after use,indicating that the low hand hygiene compliance of medical staff and the incomplete disinfection of the environment were also the causes of VAP infection in the hospital.The median of total cost of hospitalization in the case group was 145207 yuan,while that in the control group was 60745.48 yuan.The average economic loss caused by VAP infection was 84461.52 yuan each case.The medical expenses of the case group were higher than those of the control group,with a statistically significant difference(P＜0.05).Conclusions Improper diagnosis and treatment during the mechanical ventilation period,poor environmental disinfection,low hand hygiene compliance of medical staff are probably the main reasons for the occurrence of VAP in this institution.关键词
呼吸机相关性肺炎/病例对照研究/机械通气/危险因素Key words
ventilator-associated pneumonia/case-control study/mechanical ventilation/risk factors引用本文复制引用
袁倩倩,关玉花,王娜,何玉萍,琴格乐玛,古月..机械通气患者呼吸机相关性肺炎的病例对照研究[J].广州医药,2024,55(2):116-120,5.基金项目
巴音郭楞蒙古自治州人民医院院级科研项目(BHS201919) （BHS201919）
