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[1]张爱琴,葛婧,叶向红.普通外科ICU机械通气患者VAP发生率现状分析及护理对策[J].医学研究与战创伤救治(原医学研究生学报),2014,16(05):508-510,516.[doi:10.3969/j.issn.1672-271X.2014.05.020]
　ZHANG Ai-qin,GE Jing,YE Xiang-hong..The incidence and nursing measures for ventilator-associated pneumonia in general surgical ICU[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2014,16(05):508-510,516.[doi:10.3969/j.issn.1672-271X.2014.05.020]
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普通外科ICU机械通气患者VAP发生率现状分析及护理对策()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第16卷
期数:
2014年05期
页码:
508-510,516
栏目:
出版日期:
2014-09-20

文章信息/Info

Title:
The incidence and nursing measures for ventilator-associated pneumonia in general surgical ICU
作者:
张爱琴1; 葛婧2; 叶向红3
1.210002江苏南京，南京军区南京总医院护理部；2.233030安徽蚌埠，蚌埠医学院护理学系；3.210002江苏南京，南京军区南京总医院普通外科研究所
Author(s):
ZHANG Ai-qin1; GE Jing2; YE Xiang-hong3.
1.Department of Nursing,Nanjing General Hospital of Nanjing Military Command,PLA,Nanjing，Jiangsu 210002,China； 2.Department of Nursing Science,Bengbu Medical College,Bengbu，Anhui 233030,China；3.Department of Nursing,Nanjing General Hospital of Nanjing Military Command,PLA,Nanjing，Jiangsu 210002,China
关键词:
呼吸机相关性肺炎; 发生率; 高危因素; 调查分析; 干预措施
Keywords:
ventilator associated pneumonia;  incidence;  risk factors;  investigation and analysis;  preventive measures
分类号:
R563.19
DOI:
10.3969/j.issn.1672-271X.2014.05.020
文献标志码:
A
摘要:
目的对普通外科ICU机械通气患者呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)发生率现状及高危因素进行研究，为制订改进措施提供依据。方法 对入住普 通外科ICU行机械通气的178例进行观察，运用VAP集束化套餐对患者进行护理，分析VAP的高危因素，并对结果进行统计学分析。结果 普通外科ICU机械通气患者VAP发生率为17.42% ，VAP发病率平均为21.62/1000通气日，病死率12.90%，因感染VAP延长ICU住院时间为(20.7±5.72)d。VAP发生高危因素由高到低依次为：机械通气时间、人工气道的管理与更换、 呼吸机环路的更换与消毒、营养支持途径和抗生素的使用管理，发生VAP涉及医疗、护理、患者、设备等环节。结论 运用预防套餐有助于缩短机械通气时间和降低VAP发生率，VAP 高危因素中机械通气时间的比例最高，要减少VAP的发生率应对高危因素的各个环节进行综合治理。
Abstract:
Objective To evaluate the incidence of ventilator-associated pneumonia and its risk factors in the general surgical ICU and offer potential improving measures.Methods 178 patients with mechanical ventilation in the general surgical ICU were observed and VAP prevention bundle was applied.The risk factors for VAP were explored and the Results were statistically analyzed.Results The incidence of VAP was 17.42% for all patients and 21.62 per 1000 ventilation days.The overall mortality was 12.90% and the occurrence of VAP prolonged ICU stay at an average of (20.7±5.72)d.Risk factors for VAP were duration of mechanical ventilation,artificial airway management and replacement,change and disinfection of the loop,nutritional support and the use of antibiotics.Many aspects including medical management,nursing,patients,equipment etc.Conclusion The use of preventive bundles helped shorten the duration of mechanical ventilation and reduce the incidence of VAP.Mechanical ventilation duration was the most important risk factor for the development of VAP and comprehensive measures should be taken to reduce the incidence of VAP.

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备注/Memo

备注/Memo:
南京市科技发展项目(201201082)
更新日期/Last Update: 2014-09-20