目的:探讨非人工气道患者医院获得性肺炎(HAP)发生的危险因素。方法:收集北京丰台医院2006 年10 月至2008 年9 月确诊HAP 117 例非人工气道患者作为观察组,与同期未发生HAP 的117 例非人工气道患者作为对照组,采用单因素和logistic 多因素回归分析。结果:单因素分析显示年龄、吸烟、中枢神经系统疾病、慢性阻塞性肺疾病(COPD)/支气管扩张、心力衰竭、糖尿病、意识障碍、被动体位、误吸、制酸剂、抗菌素和外科手术12 种因素差异有统计学意义(P lt;0.05),是HAP 患病的可能危险因素。而无创呼吸机通气不增加HAP 发生的危险。但是logistic 多因素回归分析确定年龄、COPD/支气管扩张和外科手术是非人工气道患者HAP 发生的独立危险因素。结论:年龄、COPD/支气管扩张和外科手术是非人工气道患者HAP 发生的危险因素。
Citation:
LIU Jianqun,LI Fengqin,LIU Shanshan,et al.. Risk Factors for Hospital Acquired Pneumonia in Patients Without Artificial Airways. West China Medical Journal, 2009, 24(6): 1437-1439. doi:
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- 1. 中华医学会呼吸病学分会. 医院获得性肺炎诊断和治疗指南(草案) [J]. 中华结核和呼吸杂志, 1999, 22 (4): 201-203.
- 2. TABLAN OC, ANDERSON LJ, BESSER R, et al. Guidelines for preventing healthcareassociated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee [J]. MMWR Recomm Rep, 2004, 53 (RR3): 1-36.
- 3. CELIS R, TORRES A, GATELL JM, et al. Nosocomial pneumonia. A multivariate analysis of risk and prognosis [J]. Chest, 1988, 93 (2): 318-324.
- 4. SOPENA N, SABRI? M, Neunos 2000 Study Group. Multicenter study of hospitalacquired pneumonia in nonICU patients [J]. Chest, 2005, 127 (1): 213-219.
- 5. 康长明, 曾庆华, 杨喜耕. 医院获得性肺炎老年组与非老年组的对照分析 [J]. 华西医学, 2006, 21 (2): 351.
- 6. American Thoracic Society. Infactious Diseases Society of America. Guidelines for the management of adults with hospitalacquired, ventilatorassociated, and healthcareassociated pneumonia [J]. Am J Respir Crit Care Med, 2005, 171 (4): 388-416.
- 7. DEMOULE A, GIROU E, RICHARD JC, et al. Benefits and risks of success or failure of noninvasive ventilation [J]. Intensive Care Med, 2006, 32 (11): 1756-1765.