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目的 通过回顾性分析呼吸机相关性肺炎 (VAP)患者的临床资料和危险因素 ,提高对VAP的认识。方法 收集 1 996年 1月～ 1 999年 1 0月入住我院呼吸重症监护室行机械通气患者的临床资料 ,按诊断标准分发生VAP组和未发生VAP组 ,对两组患者的临床特点、相关危险因素、病原菌分布和预后等进行比较分析。结果 共收集病例 58例次 ,发生VAP组 2 8例次 (2 8/ 58,48 3 % ) ,未发生VAP组 30例次。发生VAP组机械通气时间明显长于未发生VAP组 (机械通气≥ 2 0d者 ,发生VAP组占 32 1 % ,未发生VAP组占 6 7% ) ,深静脉穿刺留置导管的比例也高于未发生VAP组。发生VAP组中有 2 5例次病原菌培养阳性 ,主要致病菌为不动杆菌属、真菌和铜绿假单胞菌。发生VAP组死亡9例 ,未发生VAP组死亡 2例 (P <0 0 5)。结论 VAP的发生可以显著提高病死率 ,应予重视
Objective To improve the understanding of VAP by retrospectively analyzing the clinical data and risk factors of patients with ventilator-associated pneumonia (VAP). Methods The clinical data of patients admitted to our intensive care unit from January 1996 to January 1999 were collected and divided into VAP group and VAP group according to diagnostic criteria. The clinical characteristics, Related risk factors, distribution and prognosis of pathogenic bacteria for comparative analysis. Results A total of 58 cases were collected, 28 cases (28/58, 48%) occurred in VAP group and 30 cases did not occur in VAP group. The duration of mechanical ventilation in VAP group was significantly longer than that in non-VAP group (32 days in VAP group, 32.1% in VAP group and 67% in VAP group), and the rate of deep venous catheterization was higher than that in VAP group VAP group. In the VAP group, 25 cases of pathogenic bacteria were positive for culture, and the main pathogenic bacteria were Acinetobacter, fungi and Pseudomonas aeruginosa. There were 9 deaths in VAP group and 2 deaths in VAP group (P <0 05). Conclusion The occurrence of VAP can significantly increase the mortality rate, which should be taken seriously