摘要
目的呼吸机相关性肺炎(ventilator associated pneumonia,VAP)不仅会增加患儿住院时间,给患儿及其家庭带来沉重经济负担,还会增加其痛苦,影响治疗效果以及预后。本研究分析儿科重症监护病房(pediatric intensive care unit,PICU)患儿发生VAP的高危因素。方法收集本院2016-04-01-2019-08-01诊治的333例PICU患儿临床资料,根据患儿是否发生VAP分为VAP组(50例)和非VAP组(283例),采用单因素和多因素Logistic回归分析PICU患儿发生VAP的高危因素。结果单因素分析发现,出生体质量(t=2.285,P=0.023)、插管类型(t=5.971,P=0.015)、插管次数(t=5.988,P<0.001)、机械通气时间(t=7.160,P<0.001)、早期使用抗生素(t=10.353,P=0.001)、ICU住院时间(t=5.693,P<0.001)以及吸痰次数(t=5.592,P<0.001)与PICU患儿发生VAP有关联。多因素分析显示,经口插管(OR=3.615,95%CI为1.565~8.347,P=0.003)、插管次数(OR=4.088,95%CI为1.269~13.172,P=0.019)、机械通气时间(OR=5.083,95%CI为1.553~16.640,P=0.007)、早期使用抗生素(OR=3.459,95%CI为1.161~10.306,P=0.026)以及吸痰次数(OR=4.031,95%CI为1.053~15.434,P=0.042)是导致PICU患儿发生VAP的独立危险因素。结论经口插管、插管次数过多、机械通气时间过长、早期使用抗生素以及吸痰次数过多是导致PICU患儿发生VAP的独立危险因素。
OBJECTIVE Ventilator associated pneumonia(VAP)will not only increase the hospitalization time of children,bring a heavy financial burden to children and their families,but also increase their pain,affect the treatment effect and prognosis.This study analyzes the high-risk factors for VAP in children in pediatric intensive care unit(PICU).METHODS The clinical data of 333 children with PICU diagnosed and treated in our hospital from April 01 to August 08,2016 were collected.They were divided into VAP group(50 cases)and non-VAP group(283 cases)according to whether VAP occurred or not.And multivariate Logistic regression analysis led to the risk factors of VAP in children with PICU.RESULTS Univariate analysis found that birth weight(t=2.285,P=0.023),type of intubation(t=5.971,P=0.015),number of intubations(t=5.988,P<0.001),mechanical ventilation time(t=7.160,P<0.001),early use of antibiotics(t=10.53,P=0.001),ICU hospital stay(t=5.693,P<0.001),and number of sputum aspirations(t=5.592,P<0.001)were associated with VAP in children with PICU.Multivariate analysis showed that oral intubation(OR=3.615,95%CI:1.565-8.347,P=0.003),number of intubations(OR=4.088,95%CI:1.269-13.172,P=0.019),mechanical ventilation time(OR=5.083,95%CI:1.553-16.640,P=0.007),early use of antibiotics(OR=3.459,95%CI:1.161-10.306,P=0.026)and frequency of sputum suction(OR=4.031,95%CI:1.053-15.434,P=0.042)were independent risk factors for VAP in children with PICU.CONCLUSION Oral intubation,too many intubation,time of mechanical ventilation was too long,early use of antibiotics,and too many sputum suction were independent risk factors for VAP in children with PICU.
作者
郭少林
刘九月
GUO Shao-lin;LIU Jiu-yue(Department of Pediatrics,Puyang Maternal and Child Health Hospital,Puyang457000,P.R.China)
出处
《社区医学杂志》
2020年第10期709-712,共4页
Journal Of Community Medicine
关键词
儿科
重症监护病房
呼吸机相关性肺炎
经口插管
机械通气时间
pediatrics
intensive care unit
ventilator-associated pneumonia
oral intubation
mechanical ventilation time
作者简介
通信作者:郭少林,男,河南濮阳人,硕士,主治医师,主要从事新生儿、儿童重症的研究工作。E-mail:luanbai50632209@163.com
