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目的探讨早产儿呼吸机相关性肺炎(VAP)发病危险因素和干预措施。方法采用回顾性病例对照研究,将机械通气时间≥48 h的189例早产儿根据是否发生VAP而分为病例组和对照组,进行单因素和多因素分析VAP发病的危险因素。结果早产儿VAP发生率为28.6%;病原菌以革兰阴性菌为主,占66.7%;多因素结果显示,出生体重越轻(OR=1.449)、气管插管次数越多(OR=1.690)、气管内吸引≥6次/d(OR=3.099)、机械通气时间≥5 d(OR=3.831)是早产儿VAP发生的危险因素。结论进行机械通气的早产儿具有较高的VAP发生率,VAP发生的因素较多,需采取综合预防措施来防止VAP的发生。
Objective To explore the risk factors and interventions of ventilator-associated pneumonia (VAP) in preterm infants. Methods A retrospective case-control study was conducted in 189 cases of preterm infants with mechanical ventilation ≥48 h according to whether VAP occurred or not. The univariate and multivariate analyzes were performed to analyze the risk factors of VAP. Results The incidence of VAP in preterm infants was 28.6%. Gram-negative bacteria were the most common pathogens, accounting for 66.7%. Multivariate analysis showed that the birth weight was lighter (OR = 1.449), the number of tracheal intubation was more (OR = 1.690) Tracheal suction ≥ 6 times / d (OR = 3.099), mechanical ventilation ≥ 5 d (OR = 3.831) is a risk factor for VAP in preterm infants. Conclusion The preterm infants with mechanical ventilation have a higher incidence of VAP, VAP occurs more factors, need to take comprehensive preventive measures to prevent the occurrence of VAP.