呼吸机相关性肺炎与镇静治疗的相关性研究

摘要

目的:探讨重症监护室(ICU)机械通气患者呼吸机相关性肺炎(VAP)发生率与镇静治疗的相关因素,以改善镇静治疗策略,降低VAP的发生率.方法:选取行机械通气同时使用镇静药的218例ICU患者的临床资料进行回顾性分析,将患者以是否发生VAP分为观察组(61例)和对照组(157例),比较两组患者在镇静时间,镇静评分、机械通气时间和住ICU时间的差异.结果:观察组患者总的镇静时间为(7.51±7.86)d,镇静评分为(-2.69±1.09)分,机械通气时间为(8.52±17.11)d,住ICU时间为(24.44±21.93)d,对照组患者总的镇静时间为(3.83±2.91)d,镇静评分为(-1.22±1.52)分,机械通气时间为(6.47±5.70)d,住ICU时间(11.63±7.49)d.两组差异有统计学意义(t=6.8850,t=5.0334,t=7.8012,t=6.4368;P<0.05).结论:患者机械通气镇静时间、镇静深度与VAP发生率有相关性,通过在镇静策略上进行改进,可降低VAP的发生率.%Objective:To discuss the relevant factors between occurrence rate of ventilator associated pneumonia (VAP) and sedative therapy of patients adopted mechanical ventilation in intensive care unit (ICU) so as to improve strategy of sedation and reduce occurrence rate of VAP.Methods: The clinical data of 218 patients of ICU who were implemented mechanical ventilation combined with sedative were retrospectively analyzed. All of patients were divided into observation group (61cases) and control group(157cases) according to whether happened VAP. And the differences of sedative time, score of sedation, time of mechanical ventilation and stayed time in ICU between the two groups were analyzed and compared.Results: In observation group, the total sedative time was (7.51±7.86)d, score of sedation was (-2.69±1.09), time of mechanical ventilation was (8.52±17.11)d and stayed time in ICU was (24.44±21.93)d. In control group, all of these indicators were (3.83±2.91)d, (-1.22±1.52), (6.47±5.70)d, and (11.63±7.49)d, respectively. And the differences of them between the two groups were statistically significant (t=6.8850,t=5.0334,t=7.8012,t=6.4368,P<0.05).Conclusion: The sedative time, sedative depth of patient adopted mechanical ventilation are positively relevant with the occurrence rate of VAP, and the occurrence rate can be reduced through improving the strategy of sedation.