| 摘要: |
| 目的：分析小儿重症监护病房（PICU）感染呼吸机相关性肺炎（VAP）的发病率及相关危险因素，为临床机械通气过程中VAP的防治提供参考依据。方法：选取2013年01月至2014年12月在PICU住院治疗且行机械通气时间超过48 h的419例患儿进行回顾性分析，根据是否发生VAP将其分为VAP组与非VAP组，对VAP发生的相关危险因素进行χ2检验及logistic回归分析。结果：419例机械通气时间超过48 h的患儿中，46例发生VAP，VAP的发病率为15.04%；单因素分析发现两组在基础疾病、白蛋白水平、机械通气时间、插管次数、PICU住院时间、APACHE评分、留置胃管及是否使用激素等方面差异具有统计学意义（P<0.05）；Logistic回归分析显示，白蛋白水平（OR=1.356，P<0.05）、机械通气时间（OR=2.135，P<0.01）、插管次数（OR=1.892，P<0.05）、PICU住院时间（OR=1.683，P<0.05）、APACHE评分（OR=2.642，P<0.05）、留置胃管（OR=1.869，P<0.01）为PICU患儿VAP发生的独立危险因素。结论：PICU患儿VAP的发生受多种危险因素的影响，临床上应针对相关危险因素采取有效预防措施，有效的降低VAP的发生。 |
| 关键词: 小儿重症监护病房 呼吸机相关性肺炎 发病率 危险因素 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.02.005 |
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| 基金项目:“十二五”国家重大科技支撑资助项目，编号：国科2012BA104B01-05 |
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| Risk Factor and Treatment of Ventilator-Associated Pneumonia in Pediatric Intensive Care Unit |
| Sun Yuelin, Fu Yueqiang, Ma Hongtu, Liu Chengjun, Xu Feng |
| (Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China) |
| Abstract: |
| Objective: To analyze the incidence and risk factors of ventilator-associated pneumonia (VAP) in pediatric intensive care unit (PICU), so as to provide the basic theory for VAP treatment. Methods: The retrospective analysis was studied base on the clinical data of 419 patients with mechanical ventilation for 48 hours or longer in PICU from January 2013 to December 2014. The patients were divided into VAP and non-VAP group. Single factor test and logistic regression analysis were performed on potential risk factors for VAP. Results: Totally 63 patients developed VAP, and the incidence rate was 15.04%. Single factor analysis showed primary disease, albumin levels, duration of mechanical ventilation, times of tracheal intubation, length of hospital stay, APACHE score, indwelling tube and the use of hormones were significant different between the two groups (P<0.05). The Logistic regression showed albumin levels (OR=1.356, P<0.05), duration of mechanical ventilation (OR=2.135, P<0.01), times of tracheal intubation (OR=1.892, P<0.05), length of hospital stay (OR=1.683, P<0.05), APACHE score (OR=2.642, P<0.05), indwelling tube (OR=1.869, P<0.01) were independent risk factors for VAP in PICU. Conclusion: The incidence of VAP in PICU is affected by many factors, which shouid be taken effective measures against the risk factors to reduce the incidence of VAP. |
| Key words: Pediatric intensive care unit Ventilator-associated pneumoria Incidence rate Risk factor |
