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目的:探讨重症医学科呼吸机相关性肺炎(VAP)的临床特点及预防措施。方法:对该院重症医学科2010~2011年机械通气48 h的181例新生儿的临床资料进行回顾性分析,并分析下呼吸道痰液标本所分离病原菌的菌种。结果:VAP发生率为8.29%;经口气管插管易发生VAP。病原菌主要是条件致病菌,革兰阴性菌58.33%,居前3位分别是肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌,分别为25.00%、8.33%、8.33%、8.33%;革兰阳性菌占33.33%,以缓症链球菌为主,占20.83%。结论:严格把握插管指征,加强无菌管理,防止VAP发生。
Objective: To investigate the clinical features and preventive measures of ventilator-associated pneumonia (VAP) in critical care department. Methods: The clinical data of 181 newborn infants who underwent mechanical ventilation for 48 h from 2010 to 2011 in our hospital were retrospectively analyzed. The species of pathogens isolated from sputum of lower respiratory tract were analyzed. Results: The incidence of VAP was 8.29%. VAP was easily induced by orotracheal intubation. Pathogenic bacteria are mainly opportunistic pathogens, gram-negative bacteria 58.33%, the top three were Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, respectively 25.00%, 8.33 %, 8.33% and 8.33% respectively. Gram-positive bacteria accounted for 33.33%, mainly Streptococcus mutans, accounting for 20.83%. Conclusion: Strict grasp of indications for intubation, to strengthen aseptic management, to prevent the occurrence of VAP.