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目的探讨新生儿呼吸机相关性肺炎(VAP)的高危因素和防治对策。方法对61例采用呼吸机辅助通气超过48 h的新生儿中发生的20例VAP进行总结,分析其临床高危因素。结果发生VAP20例,发生率32.79%,VAP组上机时间(5.40±2.60)d,明显长于无VAP组的(4.15±1.49)d(P<0.05)。胎龄<32周、出生体质量≤1 500 g例数显著多于无VAP组(均P<0.01)。痰液病原学检查15例阳性,其中14例为革兰阴性菌,药敏试验部分已对第3代头孢菌素耐药。结论新生儿VAP发生率高,缩短上机时间,按需吸痰减少操作次数,规范无菌操作制度,抬高体位防止误吸有利于降低VAP的发生。
Objective To investigate the risk factors of neonatal ventilator-associated pneumonia (VAP) and its prevention and treatment. Methods Twenty cases of VAP occurred in 61 neonates with ventilator - assisted ventilation for more than 48 h were analyzed and their clinical risk factors were analyzed. Results The incidence of VAP in 20 cases was 32.79%. The VAP group was significantly longer than that in the VAP group (5.40 ± 2.60) d vs (4.15 ± 1.49) d (P <0.05). The number of gestational age <32 weeks, body mass ≤ 1500g was significantly higher than that without VAP (all P <0.01). Sputum etiology 15 cases were positive, of which 14 cases of Gram-negative bacteria, drug sensitivity test part of the third-generation cephalosporin resistance. Conclusion The incidence of neonatal VAP is high, shortening the time on the machine, reducing the number of operations on demand suction, standardize the aseptic operating system, elevate the position to prevent aspiration is beneficial to reduce the occurrence of VAP.