早产儿呼吸机相关性肺炎危险因素分析

目的探讨早产儿呼吸机相关性肺炎（VAP）的危险因素。方法收集2011年1月至2012年12月在金华市中心医院住院并应用机械通气治疗时间≥48h的96例早产儿，将其分为VAP组（31例）及对照组（65例）。对两组患儿的胎龄、出生体质量、分娩方式、机械通气时间、再插管、反复气管内吸引、抗生素使用、应用猪肺磷脂注射液、镇静剂使用及静脉营养比较，并通过Logisitc回归分析预测早产儿VAP的危险因素。结果两组患儿的胎龄、出生体质量、机械通气时间、再插管、反复气管内吸引、镇静剂应用的比较差异均有统计学意义（P均〈0．05）。Logistic回归分析显示出生体质量、机械通气时间、再插管、反复气管内吸引是早产儿VAP的独立危险因素（P均〈0．05）。结论出生体质量、机械通气时间、再插管、反复气管内吸引是早产儿VAP的独立危险因素，采取综合防治措施是控制VAP的最佳策略。

Risk factors of premature with ventilator-associated pneumonia

Objective To identify the risk factors of premature with ventilator-associated pneumonia （VAP）. Methods A total of 96 prematures who admitted to the neonatal intensive care unit and received mechanical ventilation for 48 hours or longer from January 2011 to December 2012 were enrolled in this study. Among the patients, mechanical ventilated prematures suffered VAP were included in the VAP group （31 cases）, and the others were in the control group （65 cases）. The age, birth weight, delivery mode, mechanical ventilation time, reintubation, repeated trachea inner gravitation, antibiotic use, the application of pig lung phospholipids injection, sedative application and parenteral nutrition were recorded and compared. The risk factors for premature with VAP were analyzed by Logistic regression analysis. Results Statistical significances were noted in the age, birth weight, mechanical ventilation time, reintubation, repeated trachea inner gravitation and sedative application between the two groups （all P〈 0.05）. Logistic regression analysis showed that birth weight, mechanical ventilation time, reintubation and repeated trachea inner gravitation were risk factors of premature with VAP （all P 〈 0.05）. Conclusions Birth weight, mechanical ventilation time, reintubation and repeated trachea inner gravitation are the risk factors of premature with VAP, and comprehensive prevention and control measures should be taken into consideration to decrease the incidence of VAP.