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【摘要】 目的 观察机械通气并发呼吸机相关性肺炎(VAP),探讨其对患者预后影响和防治对策。方法 观察住院期间机械通气48h以上80例患者,通过观察体温、气管内吸出脓性分泌物、外周血白细胞、痰细菌培养、X线胸片,诊断呼吸机相关性肺炎。结果 机械通气48h以上80例患者,62例发生呼吸机相关性肺炎,发生率为77.5%;其中单纯致病菌38例,两种及两种以上致病菌24例。病原菌培养结果:铜绿假单胞菌28例、金黄色葡萄球菌24例、克雷伯杆菌16例,白色念珠菌14例,大肠埃希菌6例。结论 铜绿假单胞菌、金黄色葡萄球菌、克雷伯杆菌、白色念珠菌是呼吸机相关性肺炎主要致病菌;针对产生呼吸机相关性肺炎的原因进行积极防治是缩短机械通气时间和提高生存率的重要措施。
【关键词】 通气机,机械,呼吸机相关性肺炎,致病菌
Clinical analysis on 62 cases of ventilator-associated pneumonia
【Abstract】 Objective To observe the incidence of ventilator-associated pneumonia and its effects on the prognosis,and to explore preventive and therapeutic measures.Methods 80 patients who have undergone mechanical ventilation for more than 48 hours were observed.Body temperature,secretion from bronchi,leukocyte count,split bacteria culture,chest X-ray film,and diagnosis were recorded and analyzed.Results Among the 80 patients,62 (77.5%)suffered from ventilator-associated pneumonia,of which 38 cases were infected with one type of pathogen and 24 cases had two or more types of pathogen.The pathogen culture results were as follows:28 cases were positive for bacillus pyocyaneus,24 cases staphylococcus aureus,16 case bacillus klebsiella,14 cases candida,6 cases escherichia coli.Conclusions Bacillus pyocyaneus,staphylococcus aureus,bacillus klebsiella and candida are the most common pathogens of ventilator related pneumonia.According to the cause of ventilator related pneumonia,active prevention and treatment can shorten the duration of mechanical ventilation and improve survival.
【Key words】 ventilator,mechanical;pneumonia;pathogen
目录:
1 资料与方法
2 结果
3 讨论
参考文献:
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