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目的:总结ICU呼吸机肺炎(VAP)的临床治疗体会。方法:选取我单位2012年11月到2016年12月收治的使用ICU呼吸机导致肺炎的46例患者作为观察组,选取同期使用ICU呼吸机未发生任何症状的46例患者作为对照组,在比较之后,探讨患ICU呼吸机肺炎的因素和寻找预防该型肺炎的方法。结果:观察组46例患有ICU呼吸机肺炎的患者平均年龄为(59.67±13.88)岁,检查白蛋白水平为(31.43±2.34)g/L,发生误吸的例数为15例,几率为32.61%,应用糖皮质激素的例数为22例,占总数的47.83%,应用抗酸剂的患者为27例,占总数的58.70%,应用抗生素的患者为24例,占总数的52.17%;对照组46例无症状的患者平均年龄为(52.35±10.06)岁,检查白蛋白水平为(33.60±2.98)g/L,发生误吸的例数为8例,几率为17.39%,使用糖皮质激素的例数为16例,占总数的34.78%,使用抗酸剂的患者为13例,占总数的28.26%,应用抗生素的患者为18例,占总数的39.13%。观察组患者的平均年龄、应用糖皮质激素、抗酸剂以及抗生素的比例均显著高于对照组患者情况,观察组患者的白蛋白水平显著低于对照组患者水平。结论:导致ICU呼吸机肺炎的因素较多并且复杂,要加强相关研究和临床治疗水平,降低ICU呼吸机肺炎的产生率。
Objective: To summarize the clinical experience of ICU ventilator pneumonia (VAP). Methods: Forty-six patients with ICU ventilator-induced pneumonia who were admitted to our unit from November 2012 to December 2016 were selected as the observation group. Forty-six patients who did not develop any symptoms during the same period with the ICU ventilator were selected as the control group. After that, explore the factors that cause pneumonia in ICU ventilator and find ways to prevent this type of pneumonia. Results: The average age of 46 patients with ICU ventilator pneumonia in the observation group was (59.67 ± 13.88) years old, the level of albumin was (31.43 ± 2.34) g / L, the number of cases with aspiration was 15 32.61%. The number of patients receiving glucocorticoids was 22, accounting for 47.83% of the total. Among them, 27 were antacids, accounting for 58.70% of the total, 24 were antibiotics, accounting for 52.17% of the total. The average age of 46 asymptomatic patients in the control group was (52.35 ± 10.06) years, the level of albumin was (33.60 ± 2.98) g / L, the number of asymptomatic cases was 8 and the odds was 17.39% The number of hormones was 16 cases, accounting for 34.78% of the total. Among the patients using antacids, 13 cases were used, accounting for 28.26% of the total, and 18 cases were antibiotics, accounting for 39.13% of the total. The average age of patients in the observation group, glucocorticoid, antacids and antibiotics were significantly higher than those in the control group. The albumin level in the observation group was significantly lower than that in the control group. CONCLUSIONS: The factors leading to ICU ventilator pneumonia are numerous and complex. The relevant research and clinical treatment should be strengthened to reduce the incidence of ventilator pneumonia in ICU.