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目的探讨新生儿呼吸机相关性肺炎(VAP)的高危因素和防治方法。方法回顾分析2000～2005年江门市妇幼保健院NICU呼吸机治疗的98例危重新生儿的临床资料。结果VAP发生率为46.94%;VAP与胎龄、出生体重呈负相关,与机械通气(MV)时间、插管次数、MV次数呈正相关(P<0.01);病原菌主要是耐药性条件致病菌,以革兰阴性杆菌为主(80.39%),革兰阳性球菌次之(13.73%);多次上机者还培养出2株真菌;继发VAP与否明显影响治愈率(P<0.05)。结论VAP与胎龄、出生体重、MV时间、插管次数、MV次数密切相关;致病菌主要是耐药性条件致病菌;综合防治至关重要。
Objective To investigate the risk factors and prevention and cure of neonatal ventilator-associated pneumonia (VAP). Methods The clinical data of 98 critically ill newborns treated by NICU ventilator in Jiangmen MCH hospital from 2000 to 2005 were retrospectively analyzed. Results The incidence of VAP was 46.94%. VAP was negatively correlated with gestational age and birth weight, and was positively correlated with the duration of mechanical ventilation (MV), the number of intubation and MV (P <0.01). The pathogens were mainly drug-resistant Gram-negative bacilli (80.39%) and Gram-positive cocci were the second (13.73%). Two strains of fungi were also cultivated on several occasions. Secondary VAP or not significantly affected the cure rate (P <0.05) ). Conclusions VAP is closely related to gestational age, birth weight, MV time, number of intubation and MV frequency. Pathogenic bacteria are mainly drug-resistant pathogenic bacteria. Integrated prevention and treatment is very important.