Objective To discuss the risk factors of multiple organ dysfunction syndrome (MODS) patients complicated with fungal ventilator-associated pneumonia, and to provide scientific basis for nursing measures. Methods A total of 156 MODS patients complicated with ventilator-associated pneumonia were selected from January 2007 to December 2011 and divided into fungal infection group (n=60) and control group (n=96) according to the fungal culture results. Logistic regression was used to analyze the risk factors. Results Among 156 patients, 60 cases (38.5%) had pulmonary fungal infection, with mortality rate of 45.0%, which was higher than that of control group (28.1%, χ2=4.646, P<0.05). The risk factors of MODS patients complicated with fungal ventilator-associated pneumonia were as follows:mechanical ventilation days>10, the score of acute physiology and chronic health evaluation II≥25, combined antibiotics use, using glucocorticoid ≥7 days, more than two organs’ failure, airway open, hospitalization duration>30 days, using antacid and complicated with diabetes. Conclusion Various risk factors contributed to MODS complicated with fungal ventilator-associated pneumonia. Early detection of risk factors, the implementation of scientific and effective nursing interventions can improve the prognosis of the patients.% 目的探讨多器官功能障碍综合征患者并发真菌性呼吸机相关性肺炎的危险因素,为制定护理措施提供科学依据.方法选择2007年1月—2011年12月急危重症医学部收治的多器官功能障碍综合征并发呼吸机相关性肺炎的患者156例作为研究对象,根据真菌培养的结果分为真菌感染组(n=60)和对照组(n=96).采用Logistic回归分析危险因素.结果多器官功能障碍综合征患者中真菌感染组病死率为45%,高于对照组的病死率28%(χ2=4.646,P<0.05).多器官功能障碍综合征并发真菌性呼吸机相关性肺炎患者的独立危险因素包括：机械通气>10 d、急性生理功能和慢性健康状况评分Ⅱ≥25分、联合使用抗菌药物、使用糖皮质激素≥7 d、衰竭器官>2个、气管切开、住重症监护病房时间>30 d、使用制酸剂和合并糖尿病(P<0.05).结论多器官功能障碍综合征合并真菌性呼吸机相关性肺炎是多种危险因素共同作用的结果.尽早发现危险因素,针对性实施科学、有效的护理治疗干预措施,有助于改善患者的预后.
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