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目的 :为探讨机械通气患者呼吸道感染和多器官功能衰竭 (MSOF)与预后的关系。分析了 30例机械通气患者下呼吸道分泌物细菌培养和耐药试验和MSOF与死亡的关系。结果显示 :本组 30例机械通气患者中有 2 4例并发下呼吸道感染(80 % )。从 30例患者的下呼吸道分泌物中分离出 72株病原菌 ,其中G 杆菌 5 4株 (75 % ) ,尤以铜绿假单孢菌为多 (5 9% )。2 4例发生MSOF(80 % )。 16例患者死亡 (5 3.3 % )。混合菌感染组和单一菌感染组分别有 11例和 5例死亡 (p =0 .0 0 49) ,未感染组无一例死亡。MSOF组有 16例死亡 ,单器官功能衰竭组无 1例死亡 (p =0 .0 72 3)。由此可见 ,下呼吸道感染和MSOF在机械通气患者中十分常见 ;而且这两者都是引起患者死亡的主要原因。最后讨论了机械通气在下呼吸道感染和MSOF发生中的作用。
Objective: To investigate the relationship between respiratory tract infection and multiple organ failure (MSOF) and prognosis in patients with mechanical ventilation. The relationship between bacterial culture and resistance test and MSOF and death of lower respiratory tract secretions in 30 patients with mechanical ventilation was analyzed. The results showed that: in this group of 30 cases of mechanical ventilation in 24 patients with lower respiratory tract infection (80%). Seventy-two pathogens were isolated from the lower respiratory secretions of 30 patients, of which 54 (75%) were G cells, especially Pseudomonas aeruginosa (59%). In 24 cases MSOF occurred (80%). 16 patients died (5.33%). There were 11 and 5 deaths, respectively, in the mixed infection group and in the single bacterial infection group (p = 0 .049), and none in the uninfected group. There were 16 deaths in the MSOF group and none in the single organ failure group (p = .072 3). Thus, lower respiratory tract infection and MSOF are common in patients with mechanical ventilation; and both are the main causes of death in patients. Finally, the role of mechanical ventilation in the pathogenesis of lower respiratory tract infection and MSOF was discussed.