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目的了解南阳市第二人民医院新生儿机械通气并发呼吸机相关性肺炎(VAP)的发病率及相关因素,探讨其对患者预后影响和防治对策。方法观察住院期间机械通气48h以上68例患儿,通过观察呼吸音、体温、气管内吸出脓性分泌物、外周血白细胞、痰细菌培养、X线胸片诊断呼吸机相关性肺炎。结果机械通气48h以上68例患儿,19例发生呼吸机相关性肺炎,发生率为27.94%;其中一种致病菌13例,两种及两种以上致病菌6例。病原菌培养结果:铜绿假单胞菌8例、金黄色葡萄球菌4例、克雷伯杆菌6例,白色念珠菌4例,大肠埃希菌6例。结论铜绿假单胞菌、金黄色葡萄球菌、克雷伯杆菌、白色念珠菌是呼吸机相关性肺炎主要致病菌;针对新生儿产生呼吸机相关性肺炎的危险因素积极进行防治是降低VAP的发生率和提高生存率的重要措施。
Objective To investigate the incidence and related factors of ventilator-associated pneumonia (VAP) in neonates with mechanical ventilation in the Second People’s Hospital of Nanyang and discuss its influence on the prognosis of patients and the prevention and treatment measures. Methods Sixty-eight children with mechanical ventilation over 48 hours after mechanical ventilation were observed during hospitalization. Ventilator-associated pneumonia was diagnosed by observing respiratory sounds, body temperature, purulent secretions from trachea, peripheral blood leukocytes, sputum bacterial culture and X-ray. Results 68 cases of mechanical ventilation over 48h, 19 patients with ventilator-associated pneumonia, the incidence was 27.94%; one of 13 pathogens, two and more than two kinds of pathogenic bacteria in 6 cases. Pathogen culture results: Pseudomonas aeruginosa in 8 cases, Staphylococcus aureus in 4 cases, Klebsiella in 6 cases, Candida albicans in 4 cases, 6 cases of Escherichia coli. Conclusions Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae and Candida albicans are the main pathogens in ventilator-associated pneumonia. To prevent and treat VAP-related pneumonia is a risk factor for neonatal ventilator-associated pneumonia The incidence and improve the survival rate of important measures.