中国实用儿科杂志

中国实用儿科杂志

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新生儿呼吸机相关性肺炎的高危因素和防治

邓筹芬，吴玉宇，钟红磊，潘健儿，陈艳娟，江洪清，李定华   

  1. 江门市妇幼保健院儿科，广东江门529000
  • 收稿日期:2005-11-30 修回日期:2006-01-17 出版日期:2006-04-06 发布日期:2006-04-06

High risk factors,prevention and treatment of neonatal ventilatorassociated pneumonia.

Deng Choufen,Wu Yuyu,Zhong Honglei,et al.   

  1. Maternal & Child Health Care Hospital of Jiangmen，Jiangmen 529000,China
  • Received:2005-11-30 Revised:2006-01-17 Online:2006-04-06 Published:2006-04-06

摘要： 目的探讨新生儿呼吸机相关性肺炎(VAP)的高危因素和防治方法。 方法回顾分析2000~2005年江门市妇幼保健院NICU呼吸机治疗的98例危重新生儿的临床资料。 结果VAP发生率为4694%；VAP与胎龄、出生体重呈负相关，与机械通气(MV)时间、插管次数、MV次数呈正相关(P<001)；病原菌主要是耐药性条件致病菌，以革兰阴性杆菌为主(8039%)，革兰阳性球菌次之(1373%)；多次上机者还培养出2株真菌；继发VAP与否明显影响治愈率(P<005)。 结论VAP与胎龄、出生体重、MV时间、插管次数、MV次数密切相关；致病菌主要是耐药性条件致病菌；综合防治至关重要。

关键词: 新生儿, 呼吸机相关性肺炎, 高危因素, 防治

Abstract: AbstractObjectiveTo investigate the high risk factors,prevention and treatments of neonatal ventilatorassociated pneumonia. MethodsRetrospective study was made on the clinical data of 98 critical neonates who were treated with ventilator in our hospital's NICU in the latest 5 years. ResultsThe incidence of VAP was 4694%,and the gestational ages and the birth weights were negatively correlated,but the duration of MV,the times of intubation and MV were positively correlated (P<001).The main pathogens were opportunistic drugresistant bacteria,and mostly were G bacilli (8039%),then G+ cocci ( 1373%);2 strains of fungi were found in the cases of repeated MV;complicating with VAP or not had a significant effect on the cure rate (P<005). ConclusionThe incidence of VAP has a close correlation with the gestational ages,the birth weights,the duration of MV,and the times of intubation and MV.The main pathogens are drugresistant opportunistic bacteria;integrated prevention and treatment are very important.

Key words: Prevention and treatments , Ventilatorassociated pneumonia, High risk factor