回顾性分析无创机械通气患者发生医院获得性肺炎的高危因素

摘要

Objective To analyze the risk factors of hospital acquired pneumonia in patients with noninvasive mechanical ventilation.Methods 1084 severe patients were selected in ICU of our hospital from January 2013 to October 2016.All of the patients were divided into the control group (442 cases) and the observation group (642 cases) according to whether or not to accept non invasive mechanical ventilation.The incidence of hospital acquired pneumonia was observed in the two groups, and the high risk factors inducing complications were observed.Results The incidence of hospital acquired pneumonia was 5% (22/442) in the control group.Age> 60 years old, ICU length of stay> 14d, combined with hypertension, diabetes, coronary heart disease and antibiotic combined application were the independent risk factors of hospital acquired pneumonia in the control group.The incidence of hospital acquired pneumonia was 6.1% (39/642) in the observation group.APACHE Ⅱ score> 18 points, ICU length of stay> 14d and non invasive ventilation time> 7d were the independent risk factors for hospital acquired pneumonia in the observation group.Conclusion The independent risk factors of hospital acquired pneumonia in patients with non invasive mechanical ventilation are the length of stay, the time of non invasive ventilation, and the degree of the disease, who need to be paid close attention.%目的 探讨无创机械通气患者发生医院获得性肺炎的高危因素.方法 选取2013年1月至2016年9月本院ICU收治的1084例重症患者,依据是否接受无创机械通气将其分为对照组442例与观察组642例,观察两组患者的医院获得性肺炎发生率,并分别统计诱发并发症的高危因素.结果 对照组患者中医院获得性肺炎发生率为5.0%(22/442),年龄>60岁、ICU住院时间>14d、合并高血压、糖尿病、冠心病以及三联抗生素药物应用,是对照组患者发生医院获得性肺炎的独立危险因素.观察组患者的医院获得性肺炎发生率为6.1%(39/642),APACHEⅡ评分>18分、ICU住院时间>14d与无创通气时间>7d,是本组患者发生医院获得性肺炎的独立危险因素.结论 ICU住院时间、无创通气时间以及病情程度是无创机械通气患者发生医院获得性肺炎的独立危险因素,临床针对此类患者需给予密切关注.