Risk factors for hospital acquired pneumonia in patients with non-invasive mechanical ventilation

Hong Yueling; Yang Xiangmei

doi:10.13406/j.cnki.cyxb.001117

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Risk factors for hospital acquired pneumonia in patients with non-invasive mechanical ventilation

更新时间：2024-01-17

- Risk factors for hospital acquired pneumonia in patients with non-invasive mechanical ventilation
- Journal of Chongqing Medical University Vol. 42, Issue 1, Pages: 58-62(2017)
- 作者机构：
  
  重庆医科大学附属第一医院呼吸内科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.001117
  CLC： R563.1
- Published：2017，
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[1]洪跃玲,杨相梅.无创机械通气患者医院获得性肺炎相关危险因素分析[J].重庆医科大学学报,2017,42(01):58-62.

Hong Yueling, Yang Xiangmei. Risk factors for hospital acquired pneumonia in patients with non-invasive mechanical ventilation. [J]. Journal of Chongqing Medical University 42(1):58-62(2017)
[1]洪跃玲,杨相梅.无创机械通气患者医院获得性肺炎相关危险因素分析[J].重庆医科大学学报,2017,42(01):58-62. DOI： 10.13406/j.cnki.cyxb.001117.

Hong Yueling, Yang Xiangmei. Risk factors for hospital acquired pneumonia in patients with non-invasive mechanical ventilation. [J]. Journal of Chongqing Medical University 42(1):58-62(2017) DOI： 10.13406/j.cnki.cyxb.001117.

摘要

目的:探讨无创机械通气患者发生医院获得性肺炎（hospital acquired pneumonia

HAP）的相关危险因素

从而为临床实施干预提供参考依据。方法:回顾性分析某三甲医院2014年12月至2016年2月呼吸内科重症监护室440例无创机械通气患者的临床资料

采用logistic回归分析发生HAP的高危因素。结果:440例无创机械通气患者中发生HAP15例

感染发生率为3.41%;单因素分析结果显示

合并糖尿病、APACHEⅡ评分

18分、ICU住院天数

10 d、无创机械通气时间

7 d、血清白蛋白水平低于25 g/L、留置胃管、呼吸机管路使用时间

7 d以及人工吸痰都与无创机械通气患者发生HAP具有相关性（P

0.05）;多因素分析结果显示

APACHEⅡ评分

18分（OR=4.665

95%CI=1.2

8.134

P=0.026）、ICU住院天数

10 d（OR=11.261

95%CI=2.234

6.757

P=0.003）以及人工吸痰（OR=12.561

95%CI=2.846

5.441

P=0.000）是无创机械通气患者发生HAP的独立危险因素。结论:病情危重、ICU住院时间较长（

10 d）以及患者自主排痰能力较差需人工吸痰的无创机械通气患者发生HAP的感染率较高

如果患者存在以上危险因素

应加强对HAP的预防。

Abstract

Objective:To explore the risk factors for hospital acquired pneumonia(HAP)in patients with non-invasive mechanical ventilation so as to provide some guidance for clinical intervention. Methods:The clinical data of patients with non-invasive mechanical ventilation were retrospectively analyzed. Results:HAP occured in fifteen patients(out of 440 patients)with non-invasive ventilation acquired pneumonia with the infection rate being 3.41%. The results of univariate analysis showed that the incidence of HAP in patients with noninvasive mechanical ventilation was associated with diabetes mellitus

APACHEⅡscore >18 points

ICU stay >10days

duration of noninvasive ventilation >7 days

serum albumin lower than 25 g/m L

indwelling gastric tube and artificial sputum suction(P<0.05);the multivariate logistic regression analysis showed that APACHE Ⅱ score >18 points(OR=4.665

95%CI=1.2 to18.134

P=0.026)

ICU stays >10 days(OR=11.261

95%CI=2.234 to 56.757

P=0.003)and repeated artificial sputum(OR=12.561

95%CI=2.846 to 55.441

P=0.000) were the independent risk factors for the hospital acquired pneumonia in patients(P <0.05).Conclusion:More attention should be paid to the patients with non-invasive mechanical ventilation when they are in critical condition

staying in ICU for a long time(>10 days)and needing sputum suction to prevent HAP.

关键词

无创机械通气医院获得性肺炎高危因素

Keywords

Non-invasive mechanical ventilationhospital acquired pneumoniarisk factor

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