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目的:了解新生儿呼吸机相关性肺炎(VAP)的危险因素、病原菌及用药情况。方法:采用相关因素分析法分析新生儿VAP的危险因素,以VAP发生率为指标评价抗生素疗效。结果:分娩方式及机械通气时间可能为VAP的危险因素。肺炎克雷伯菌和鲍曼不动杆菌为新生儿VAP主要病原菌。抗生素疗效评价显示,联合用药预防VAP的有效性为66.67%～85.71%,而单药预防仅为57.14%。结论:依据病原菌分布和药敏试验结果,推荐将广谱抗生素作为本地区新生儿VAP经验性用药。抗生素联合用药预防VAP优于单药预防,但此结果仍有待进一步研究证实。
Objective: To understand the risk factors of neonatal ventilator-associated pneumonia (VAP), pathogens and medication. Methods: The risk factors of neonatal VAP were analyzed by correlation analysis, and the effect of antibiotics was evaluated by the incidence of VAP. Results: Mode of delivery and duration of mechanical ventilation may be risk factors for VAP. Klebsiella pneumoniae and Acinetobacter baumannii are the main pathogens of neonatal VAP. Antibiotic efficacy evaluation showed that the combination of drugs to prevent the effectiveness of VAP 66.67% ~ 85.71%, while the single drug prevention was only 57.14%. Conclusion: Based on the distribution of pathogens and drug susceptibility test results, it is recommended that broad-spectrum antibiotics be used as empirical medication for neonatal VAP in this area. Antibiotic combination therapy is superior to monotherapy in the prevention of VAP, but the results remain to be confirmed by further studies.