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目的探讨人工气道干预后呼吸机相关性肺炎(VAP)发生的危险因素及其护理措施。方法选取中江县人民医院2013年4月—2015年4月经人工气道干预后罹患VAP患者84例,根据有无感染VAP分为VAP组42例和无VAP组42例。采用多因素Logistic回归分析其相关致病危险因素,提出相应的护理措施。结果两组患者年龄、性别、病因比较,差异无统计学意义(P>0.05);VAP组患者留置胃管率、通气时间>10 d率、认知障碍发生率、穿刺置管率高于无VAP组(P<0.05)。多因素Logistic回归分析结果显示,留置胃管、通气时间>10 d、认知障碍及穿刺置管是人工气道干预后VAP发生的独立危险因素(P<0.05)。结论留置胃管、通气时间>10 d、认知障碍及穿刺置管是人工气道干预后VAP发生的独立危险因素,因此临床应加强护理措施,针对性预防VAP的发生及发展。
Objective To explore the risk factors of ventilator-associated pneumonia (VAP) after artificial airway intervention and its nursing measures. Methods 84 patients with VAP who were treated with artificial airway intervention in Zhongjiang County People’s Hospital from April 2013 to April 2015 were divided into 42 patients in VAP group and 42 patients in VAP group according to the presence or absence of VAP. Multivariate Logistic regression analysis of its risk factors related to the proposed nursing measures. Results There were no significant differences in age, sex and etiology between the two groups (P> 0.05). The rate of gastric tube placement, ventilatory time> 10 d, the incidence of cognitive impairment and the catheterization rate in VAP group were higher than those without VAP group (P <0.05). Multivariate logistic regression analysis showed that indwelling gastric tube, ventilation time> 10 d, cognitive impairment and catheterization were independent risk factors of VAP after artificial airway intervention (P <0.05). Conclusion Indwelling gastric tube, ventilation time> 10 d, cognitive impairment and catheterization are independent risk factors of VAP after artificial airway intervention. Therefore, nursing measures should be strengthened to prevent and control VAP.