摘要
目的:探究影响新生儿呼吸机相关性肺炎(VAP)的危险因素及早期干预对可控因素的影响效果。方法:回顾性分析86例通过呼吸机治疗的新生儿临床资料,根据是否发生VAP分为VAP组与非VAP组。将VAP组与非VAP组患儿各项临床资料进行单因素分析,对单因素分析存在明显差异指标进行非条件Logistic多元逐步回归分析。另选取78例具备呼吸机治疗指征的新生儿为受试对象,随机数表法分为观察组与对照组各39例。对照组仅采取常规干预措施,观察组则在其基础上对上述所得危险因素中的可控因素进行针对性早期干预。比较两组患儿住院期间基本情况差异。结果:低胎龄、多次辅助排痰、有胃内容物吸入、机械通气时间较长均是导致新生儿VAP的独立危险因素(P <0. 05)。观察组患儿辅助排痰次数、胃内容物吸入例数、机械通气时间、住新生儿重症监护室(NICU)时间、住院时间、VAP发病例数均少于对照组,差异均有统计学意义(P <0. 05)。结论:影响新生儿VAP的独立危险因素包括低胎龄、多次辅助排痰、有胃内容物吸入、机械通气时间较长,对可控因素进行早期干预可有效减少VAP发生风险。
Objective：To explore the risk factors of ventilator- associated pneumonia （VAP） in neonates and the effect of early intervention on controllable factors. Methods ： The clinical data of 86 neonates treated with ventilator were analyzed retrospectively. According to whether VAP occurred, they were divided into VAP group and non - VAP group. The clinical data of VAP group and non - VAP group were analyzed by univariate analysis, and the indexes with signifi- cant difference in univariate analysis were analyzed by unconditional logistic multivariate stepwise regression analysis. Another 78 neonates with indications of ventilator therapy were selected as subjects and randomly divided into observation group and control group with 39 cases in each group. The control group was only given routine intervention, while the observation group was given early intervention on the basis of the controllable factors. The diffel^nce between the two groups during hospitalization was compared. Results：Low gestational age, multiple assisted expectoration, inhalation of gastric contents and long mechanical ventilation were independent risk factors for neonatal VA P （P 〈 0.05 ）. The num- ber of assisted expectoration, gastric contents inhalation, mechanical ventilation, neonatal intensive care unit （NICU） , hospitalization and VAP incidence in the observation group were less than those in the control group （P 〈 0.05）. Conclusions：Independent risk factors affecting neonatal VAP include low gestational age, multiple assisted expectoration, inhalation of gastric contents, and prolonged mechanical ventilation. Early intervention of controllable factors can effectively reduce the risk of VAP.
作者
何颖
HE Ying(Quanzhou Maternal and Children Health Care Hospital Children＇s Hospital, Quanzhou 362000, Fujian, China)
出处
《山西职工医学院学报》
CAS
2018年第5期3-6,共4页
Journal of Shanxi Medical College for Continuing Education
关键词
新生儿
呼吸机相关性肺炎
危险因素
早期干预
neonatal
ventilator - associated pneumonia
risk factors
early intervention
