[1]何广宾,左海涛,陈永青.呼吸机相关性肺炎对急性呼吸窘迫综合征患者预后的影响[J].医学信息,2022,35(11):89-92.[doi:10.3969/j.issn.1006-1959.2022.11.023]
　HE Guang-bin,ZUO Hai-tao,CHEN Yong-qing.Effect of Ventilator Associated Pneumonia on Prognosis of Patients with Acute Respiratory Distress Syndrome[J].Medical Information,2022,35(11):89-92.[doi:10.3969/j.issn.1006-1959.2022.11.023]
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呼吸机相关性肺炎对急性呼吸窘迫综合征患者预后的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年11期
页码:
89-92
栏目:
论著
出版日期:
2022-06-01

文章信息/Info

Title:
Effect of Ventilator Associated Pneumonia on Prognosis of Patients with Acute Respiratory Distress Syndrome
文章编号:
1006-1959（2022）11-0089-04
作者:
何广宾; 左海涛; 陈永青
（三河燕郊福合第一医院内科，河北 三河 065201）
Author(s):
HE Guang-bin; ZUO Hai-tao; CHEN Yong-qing
(Department of Internal Medicine,Sanhe Yanjiao Fuhe First Hospital,Sanhe 065201,Hebei,China)
关键词:
急性呼吸窘迫综合征; 呼吸机相关性肺炎; 死亡率; 危险因素
Keywords:
Acute respiratory distress syndrome; Ventilator associated pneumonia; Mortality; Risk factors
分类号:
R563.1
DOI:
10.3969/j.issn.1006-1959.2022.11.023
文献标志码:
A
摘要:
目的 研究呼吸机相关性肺炎（VAP）对肺保护性通气治疗的急性呼吸窘迫综合征（ARDS）患者预后的影响。方法 选择2015年6月-2019年6月在我院ICU接受肺保护性机械通气治疗的ARDS患者195例，根据有无并发VAP将患者分为VAP组（59例）和对照组（136例）。收集两组年龄、性别、原发疾病、呼吸道病原菌培养结果等临床资料，比较两组呼吸机参数、动脉血气、入院时Glasgow评分及28 d死亡率，分析发生VAP的危险因素。结果 两组年龄、耐甲氧西林金黄色葡萄球菌（MASA）感染、入院Glasgow评分、机械通气时间及应用质子泵抑制剂情况比较，差异有统计学意义（P＜0.05）；VAP组28 d死亡率高于对照组（35.59% vs 30.15%），但差异无统计学意义（P＞0.05）；多因素Logistic回归分析显示，入院Glasgow评分＜8分、机械通气时间＞2周、应用质子泵抑制剂是ARDS并发VAP的危险因素。结论 VAP未增加ARDS患者的死亡率，入院Glasgow评分＜8分、机械通气时间＞2周、应用质子泵抑制剂是ARDS并发VAP的风险因素。
Abstract:
Objective To investigate the effect of ventilator associated pneumonia (VAP) on the prognosis of patients with acute respiratory distress syndrome (ARDS) treated with lung protective ventilation.Methods A total of 195 patients with ARDS who underwent lung protective mechanical ventilation in ICU of our hospital from June 2015 to June 2019 were selected. According to the presence or absence of VAP, the patients were divided into VAP group (59 cases) and control group (136 cases). The clinical data of age, gender, primary disease and respiratory pathogen culture results were collected. The ventilator parameters, arterial blood gas, Glasgow score at admission and 28 d mortality were compared between the two groups. The risk factors of VAP were analyzed.Results There were statistically significant differences in age, methicillin-resistant Staphylococcus aureus (MASA) infection, Glasgow score on admission, duration of mechanical ventilation and proton pump inhibitor application between the two groups (P<0.05). The mortality of VAP group was higher than that of control group (35.59% vs 30.15%), but the difference was not statistically significant (P>0.05). Multivariate Logistic regression analysis showed that admission Glasgow score for 2 weeks and application of proton pump inhibitors were risk factors for ARDS complicated with VAP.Conclusion VAP does not increase the mortality of ARDS patients. Glasgow score at admission for 2 weeks and proton pump inhibitors are risk factors for ARDS complicated with VAP.

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更新日期/Last Update: 1900-01-01