呼吸科无创机械通气老年患者医院获得性肺炎的致病菌分布及影响因素分析
Pathogenic bacteria and influencing factors of hospital acquired pneumonia in elderly patients with noninvasive mechanical ventilation in respiratory department
金亮 1施斌 1孙旺远1
作者信息
- 1. 南京鼓楼医院集团宿迁医院,江苏宿迁 223800;徐州医科大学附属宿迁医院
- 折叠
摘要
目的 明确呼吸科无创机械通气老年患者医院获得性肺炎的致病菌分布及危险因素.方法 选取某医院呼吸科无创机械通气治疗的493例老年患者为研究对象,统计并分析呼吸科无创机械通气老年患者的医院获得性肺炎的发生情况、致病菌分布及发生医院获得性肺炎的危险因素.结果 呼吸科的493例无创机械通气老年患者,有38例(7.71%)罹患医院获得性肺炎,共检出了53株致病菌,革兰阴性菌、革兰阳性菌与真菌分别有31株(58.49%)、15株(28.30%)和7株(13.21%).多因素logistic分析结果筛选出呼吸科无创机械通气老年患者医院获得性肺炎的危险因素包括年龄≥75岁、意识不清醒、合并吞咽困难、合并低蛋白血症、反流误吸、使用无创呼吸机时间≥7 d、呼吸机回路的更换频率≥5 d/次,以及使用广谱抗菌药物.结论 呼吸科无创机械通气老年患者医院获得性肺炎的发生率较高,主要病原菌为革兰阴性菌,真菌也占有一定比例,其影响因素较多,应引起呼吸科医生的关注.
Abstract
Objective To determine the pathogenic bacteria and influencing factors of hospital-acquired pneumonia in elderly patients with noninvasive mechanical ventilation in respiratory department.Methods A total of 493 elderly patients treated with noninvasive mechanical ventilation in the respiratory department of our hospital were selected as the research objects.The incidence,pathogen distribution and risk factors of hospital-acquired pneumonia in elderly patients with noninvasive mechanical ventilation in the respiratory department were counted and analyzed.Results Of the 493 elderly patients with noninvasive mechanical ventilation in the respiratory department,38(7.71%)suffered from hospital-acquired pneumonia.A total of 53 strains of pathogenic bacteria were detected,including 31 strains(58.49%)of Gram-negative bacteria,15 strains(28.30%)of Gram-positive bacteria and 7 strains(13.21%)of fungi.Multivariate logistic analysis showed that the risk factors of hospital acquired pneumonia in elderly patients with noninvasive mechanical ventilation in respiratory department were:age≥75 years old,unconsciousness,dysphagia,hypoproteinemia,reflux aspiration,time of using noninvasive ventilator≥7 days,frequency of replacing ventilator circuit≥5 days/time and use of broad-spectrum antibiotics.Conclusion The incidence of hospital acquired pneumonia in elderly patients with noninvasive mechanical ventilation in respiratory department is high.The main pathogen is Gram-negative bacteria,and fungi also account for a certain proportion.There are many influencing factors,which should attract the attention of respiratory doctors.
关键词
呼吸科/无创机械通气/医院获得性肺炎/致病菌/影响因素Key words
department of respiratory/noninvasive mechanical ventilation/hospital acquired pneumonia/pathogenic bacteria/influencing factors引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据