PICU機械通氣呼吸機管路的病原學分析王文超;張玉俠;賀駿;胡靜;鄭冬;侯添彧(PICU)經鼻或經口氣管插管行有創通氣的患PICU4248h71420(47.62%)1008210株。下呼吸道]PICUPICU《護理研究》2016(030)033【總頁數】5頁(P4198-4201,4201)【關鍵詞】兒童;機械通氣;病原學分析;呼吸機相關性肺炎;PICU【作者】王文超;張玉俠;賀駿;胡靜;鄭冬;侯添彧【作者單位】201102，復旦大學附屬兒科醫院;201102;201102;201102復旦大學附屬兒科醫院;201102【正文語種】中文【中圖分類】R473.72PICU201512015575呼吸機。排除上機后7d3342例。2418216(3.33±3.9621.17d±16.00d；66.7%,方法h714320min內立刻送檢至檢驗科。檢驗科人員48h,48h48h7141999年中華醫學會呼吸病學分會48h后發病；>10.0×109/L<4.0×109/L。伴或不伴核左移；體溫>38.0新的病原體。統計學方法采用SPSS19.0P<0.05為差異有統計學意義。47.62%1100821014763275%以上與在呼吸機管路中培養得到的細菌菌種相同。通過一致性Y38.46%,比比較差異有統計學意義(χ2=8.501,P=0.037)。3)加強呼吸機管道的規范化管理4247.62%,Y752.4%73沒有明顯差異72Meta7d1d～3d7d～14d發病率7d換較為合適。48h14推進呼吸機相關性肺炎預防的集束化護理策略[830°～45°8h1pH[9]器進行氣道濕化；呼吸機管道有明確污染時進行管道更換；采用持續的聲門下吸引。根據美國醫療改進中心的建議,預防呼吸機相關性肺炎的集束化干預策略包括床頭抬高、口腔護理、鎮靜喚醒、消化道潰瘍的預防和深靜脈栓塞的預防。2222.6%～45.1%[11]31%～57%,42【相關文獻】EdwardsJP,PetersonKD，AndrusML.NationalHealthCaresafetyNetwork(NHSN)report,datasummaryfor2006[J].AmJInfectControl,2007,35(5):290-301.SamransamruajkitR,JirapaiboonsukS,SiritantiwatS,etal.Effectoffrequencyofventilatorcircuitchanges(3vs7days)ontherateofventilator-associatedpneumoniaPICU[J].JournalofCriticalCare,2010,25(1):56-61.王曉艷.ICU,2010:1.2010,25(12):1092-1093.RelloJA,LisboaET.Acarebundleapproachforpreventionofventilator-associatedpneumonia[J].ClinicalMicrobiologyandInfection,2013,19(4):363-369.Meta分析雜志，2011,21(12):1471-1475.ChoiJS,YeonJH.Ventilator-associatedpneumoniawithcircuitchangesevery7versusevery14days[J].JournalofKoreanAcademyofNursing,2010,40:799-807.CasonCL,TynerS.Nurses’implementationofguidelinesforassociatedpneumoniafromthecenterfordiseasecontrolandprevention[J].AmJCare,2007,16(1):28-36.HeylanclDK,DroverJW,MacDonaldS,etal.Effectofpostpyloricfeedingongastroesophagealregurgitationandpulmonarymicroaspiration:esultsofarandomizedcontrolledtrial[J].CritCareMed,2001,29(8):1495-1501.ChendrasekharA,TimberlakeG.Endotrachealtubecuffpressurethresholdpreventionofnosocomialpneumonia[J].JApplRes,2003,3(3):311-314.LabeauS,VandijckD,RelloJ,etal.Evidence-basedguidelinesforthepreventionventilator-associatedpneumonia:resultsofaknowledgetestamongEuropeanintensivecarenurses[J].JHospInfect,2007,70(2):180-185.GastmeierP.Preventionofventil