摘要
目的 分析和探讨ICU机械通气患者进行雾化吸入操作的不良后果.方法 对2015年4-12月进入华西医院中心ICU的所有机械通气患者进行回顾性调查研究,用SPSS 18.0统计软件进行统计,分析机械通气患者雾化吸入操作后定植或感染下呼吸道多重耐药菌（MDRO）及发生呼吸机相关性肺炎（VAP）的风险性是否增加.结果 共调查机械通气患者922例,其中雾化吸入160例,定植或感染下呼吸道MDRO 92例,发生VAP 18例.定植或感染下呼吸道MDRO的患者和未定植者做雾化吸入的比例分别为30.4%（28/92）、15.9%（132/830）,差异有统计学意义（χ^2=12.193,P=0.000）;发生VAP者和未发生VAP者做雾化吸入的比例分别为50.0%（9/18）、16.7%（151/904）,差异有统计学意义（χ^2=11.420,P=0.000）.经多因素回归分析,雾化吸入是机械通气患者下呼吸道定植或感染MDRO（OR=1.917,95%CI 1.163-3.159,P=0.011）和发生VAP（OR=4.613,95%CI 1.773-12.002,P=0.000）的独立危险因素.结论 ICU机械通气患者进行雾化吸入增加了患者定植或感染下呼吸道MDRO及发生VAP的风险,故机械通气患者应当减少不必要的、频繁的雾化吸入操作.
Objective To analyze and discuss the negative effects of atomization inhalation in mechanical ventilation patients in intensive care unit. Methods A retrospective study of all the mechanical ventilation patients in the general ICU of our hospital was carried out from Aprilto December 2015. The risk of multidrug-resistant organisms（MDROs）colonizationin the lower respiratory tract and ventilation associated pneumonia（VAP）in mechanical ventilation patients were analyzed. Results A total of 922 patients were monitored, 160 of whom had atomization inhalation, 92 for MDROs colonizationin the lower respiratory tract and 18 for VAP. The rates ofatomization inhalation in patients with and without MDROs colonizationin the lower respiratory tract were 30.4%（28/92）and 15.9%（132/830）with statistical difference （χ^2=12.193, P=0.000）. And those in patients with and without VAP were 50.0%（9/18） and 16.7%（151/904）, with statistical difference （χ^2=11.420, P=0.000）. Atomization inhalation was the independent risk factor both of MDROs colonizationin the lower respiratory tract（OR=1.917, 95%CI1.163-3.159, P=0.011） and VAP（OR=4.613, 95%CI 1.773-12.002, P=0.000） in mechanical ventilation patients. Conclusions Atomization inhalation may increase the risk of MDROs colonizationin the lower respiratory tract and VAP in mechanical ventilation patients. Thus unnecessary and too frequent operations of atomization inhalation should be decreased.
出处
《中国实用护理杂志》
2017年第16期1256-1259,共4页
Chinese Journal of Practical Nursing
关键词
肺炎
呼吸机相关性
重症监护室
护理操作
雾化吸入
多重耐药菌
Pneumonia
ventilator- associated
Intensive care unit
Nursing procedures
Atomization inhalation
Multidrug-resistant organism
