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目的了解重症监护病房(ICU)呼吸机相关性事件(VAE)的发生状况,为制定干预措施提供参考依据。方法采用前瞻性监测方法,对2013年4月1日-7月31日所有入住ICU且使用机械通气时间>2 d、年龄≥18岁的患者进行VAE监测,并与2012年同期呼吸机和相关性肺炎(VAP)监测情况进行比较。结果监测到有效病例31例,共发生VAE 6例,发生率为19.35%;患者平均住院时间12 d,平均机械通气时间10 d;预后:存活25例,死亡6例,病死率为19.35%;抗菌药物使用率100%。2013年的VAE监测与2012年同期院内VAP目标性监测VAP千日感染率分别为2.83、29.57例/1 000导管日,差异有统计学意义(P<0.05)。结论 VAE监测及其诊断标准客观量化、简单易行,但是否适用于我国ICU患者VAP的诊断,值得商榷。
Objective To understand the occurrence of ventilator-related events (ICE) in intensive care unit (ICU) and provide a reference for the formulation of interventions. Methods A prospective monitoring method was used to monitor VAE in all patients admitted to the ICU from April 1 to July 31, 2013 and using mechanical ventilation for more than 2 days and age ≥18 years. Pneumonia (VAP) monitoring compared. Results A total of 31 valid cases were detected, including 6 cases of VAE, the incidence rate was 19.35%. The average length of hospital stay was 12 days and the mean duration of mechanical ventilation was 10 days. The prognosis was 25 cases of survival and 6 cases of death, the mortality was 19.35%. Antimicrobial usage 100%. The prevalence rates of VAP in 2013 and VAP in 2012 were 2.83,29.57 cases / 1,000 catheter days, respectively. The difference was statistically significant (P <0.05). Conclusion VAE monitoring and its diagnostic criteria objectively quantified, simple and easy, but whether it is suitable for the diagnosis of VAP in patients with ICU in our country, is debatable.