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目的分析先天性心脏病(先天心)新生儿围手术期合并呼吸机相关性肺炎(ventilator-associatedpneumonia,VAP)的发病危险因素;为预防和控制VAP提供科学依据。方法对47例先天心新生儿外科手术治疗呼吸机支持48小时后所发生的17例VAP行回顾性分析,用logistic回归分析方法,筛选VAP发病的可能危险因素。结果本组VAP发生率为38.6%,其发生率与呼吸机治疗,镇静药、麻醉药和肌松药应用的时间差异有统计学意义,呼吸机延长1日VAP增加2.314倍。与体重、性别、疾病的类型和体外循环无关。结论呼吸机使用时间是新生儿先天心术后合并VAP的关键因素,应尽早脱离呼吸机治疗,去除气管插管,以便减少VAP的发生。对已筛选的可能危险因素,需通过临床试验进一步证实。
Objective To analyze the risk factors of perioperative ventilator-associated pneumonia (VAP) in neonates with congenital heart disease (congenital heart disease) and to provide a scientific basis for the prevention and control of VAP. Methods Retrospective analysis of 17 cases of VAP occurred in 47 cases of congenital heart neonate with surgical treatment of ventilator support 48 hours later. Logistic regression analysis was used to screen the possible risk factors of VAP. Results The incidence of VAP in this group was 38.6%. The incidence of VAP in this group was significantly different from that of ventilator therapy, sedatives, anesthetics and muscle relaxants. VAP increased 2.314-fold on the 1st day of ventilator extension. And weight, gender, type of disease and has nothing to do with cardiopulmonary bypass. Conclusion The time of ventilator is the key factor of neonatal congenital heart surgery complicated with VAP. The ventilator should be removed from the ventilator as soon as possible to remove the endotracheal intubation in order to reduce the occurrence of VAP. The screening of possible risk factors, to be further confirmed by clinical trials.