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目的分析探讨极低出生体重儿呼吸机相关性肺炎(VAP)的临床特点。方法收集2009年8月-2011年8月来我院的新生儿重症监护病房(NICU)行机械通气48h以上的75例新生儿的痰液培养资料,对痰液标本进行病原菌的分离和耐药性的检验分析。结果在NICU进行机械通气治疗的75例患儿中,有36例VAP患儿痰液标本共培养出病原菌36株,其中22.2%革兰阳性球菌,有63.9%革兰阴性杆菌,且大多数为耐药,13.9%为真菌;VAP患儿的死亡率19.4%,明显高于非VAP患儿的2.6%,差异有统计学意义(P<0.05)。结论对于行机械通气的患儿,分析其痰培养中的病原菌,可用于VAP的早期诊治,适合临床推广。
Objective To analyze the clinical features of ventilator-associated pneumonia (VAP) in very low birth weight infants. Methods A total of 75 neonates with sputum culture data collected from neonatal intensive care unit (NICU) in our hospital from August 2009 to August 2011 undergoing mechanical ventilation for more than 48 hours were collected for isolation of pathogens and drug resistance Sexual test analysis. Results Of the 75 children with NICU who received mechanical ventilation, 36 sputum samples of VAP children were co-cultured with 36 pathogens, of which 22.2% were Gram-positive cocci with 63.9% Gram-negative bacilli and most of them were 13.9% were fungi. The mortality rate of VAP children was 19.4%, which was significantly higher than that of non-VAP children (2.6%), the difference was statistically significant (P <0.05). Conclusion For children with mechanical ventilation, analyzing the pathogenic bacteria in sputum culture can be used for the early diagnosis and treatment of VAP and is suitable for clinical promotion.