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肿瘤患者呼吸机相关性肺炎危险因素相关分析

         

摘要

Objective To investigate the risk factors for ventilator associated pneumonia ( VAP) in oncology patients and improve the clinical medical security .Methods 98 cancer patients with mechanical ventilation ventilator-assisted breat-hing, they were underwent mechanical ventilation >48 h, depend on whether the occurrence of ventilator-associated pneumoni-a infections for judging standards , these patients are divided into infected groups (30 cases) and non-infected group (68 ca-ses) .Using Univariate analysis to analyses the difference in ventilator-associated pneumonia risk factors between the two groups, and further analyzed independent risk factors of ventilator-associated pneumonia by Logistic regression .Results Uni-variate analysis showed that:infection group's age, duration of mechanical ventilation, use of steroids, unconsciousness, in-dwelling stomach tube, APACHEII score and supine position were higher than non-infected group ( P <0.05).Multivariate analysis showed that:infected group's age (OR=1.087,95%CI 1.018-1.161), duration of mechanical ventilation (OR=5.148,95%CI 1.342-19.743),indwelling stomach tube (OR=1.074,95% CI 1.011-1.141) and APACHEII score (OR =1.336,95%CI 1.130-1.580) were higher than those of non-infected group ( P <0.05).Conclusion Older age, long time of mechanical ventilation , indwelling gastric tube and high APACHEⅡ score were the independent risk factor of VAP.%目的:探讨肿瘤患者呼吸机相关性肺炎发生的相关危险因素。方法机械通气呼吸机辅助呼吸的肿瘤患者98例,均机械通气>48 h,以是否发生呼吸机相关性肺炎为判断标准分为感染组(30例)和非感染组(68例)。采用单因素分析2组间呼吸机相关性肺炎危险因素的差异,并进一步通过多因素Logistic回归分析影响呼吸机相关性肺炎发生的独立危险因素。结果单因素分析表明:感染组年龄、机械通气时间、应用激素、意识障碍、留置胃管、APACHEII评分及平卧位均高于非感染组( P <0潩.05)。多因素分析表明:感染组年龄(OR=1.087,95%CI 1.018~1.161)、机械通气时间(OR =5.148,95%CI 1.342~19.743)、留置胃管(OR=1.074,95%CI 1.011~1.141)及APACHEII评分(OR=1.336,95%CI 1.130~1.580)均高于非感染组( P <0.05)。结论年龄大、机械通气时间长、留置胃管及APACHEⅡ评分高是发生呼吸机相关性肺炎的独立危险因素。

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