干旱区生态环境知识资源中心(Arid): 肺外科术后呼吸机相关肺炎临床分析

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	肺外科术后呼吸机相关肺炎临床分析
其他题名	The clinical features of postoperative ventilator-associated pneumonia after lung surgery
	王兴安; 童稳圃; 姜格宁; 丁嘉安; 周逸鸣
ISSN	0529-5815
出版年	2006
卷号	44 期号:18 页码:1225-1228
中文摘要	目的研究肺外科术后呼吸机相关肺炎(VAP)的临床特点.方法 2003年1月至2005年3月我院收治的肺外科术后机械通气患者104例中,同时符合VAP和术后肺炎(POP)诊断者35例,无肺炎临床证据的41例.分析76例患者的临床和实验室资料.结果术后VAP临床诊断35例(46.1%),病原学诊断33例.术后VAP患者手术距离插管天数[(2.72.9)d vs.(1.61.7)d,P=0.039]、机械通气时间[(32.237.7)d vs.(4.22.9)d,P＜0.001]和病死率(20.0%vs.2.4%,P=0.013)明显高于没有术后VAP的患者.15例早发性和20例迟发性术后VAP患者在机械通气时间上差异有统计学意义[(1715)d vs.(4346)d,P=0.042].分析首次检测到的病原菌,革兰阳性菌仍以金黄色葡萄球菌最多见,鲍曼不动杆菌取代铜绿假单胞菌而居革兰阴性菌之首.结论肺外科术后VAP有不同于内科VAP的临床特点.
英文摘要	To investigate the clinical features of postoperative ventilator-associated pneumonia (VAP) after lung surgery. Methods Of 104 patients who had undergone lung surgery and been treated with ventilator in our surgical intensive care unit between January 2003 and March 2005, 35 patients met with the criteria of both VAP and postoperative pneumonia ( POP) , and 41 cases had no evidences of pneumonia. The clinical and laboratory data of all 76 eases were recorded and analyzed by a statistical software package ( SPSS). Results The diagnosis of postoperative VAP was established clinically in 35 patients (46. 1% ) , and etiologically in 33 oases. Compared to the patients without postoperative VAP, the patients with postoperative VAP had a significantly longer mean interval between intubation and operation [ (2. 7 2. 9) days vs. (1. 6 1. 7) days, P =0. 039] , a longer duration of mechanical ventilation [ (32. 2 37. 7) days vs. (4. 2 2. 9) days, P <0. 001 ] , and higher morbidity (20. 0%vs. 2. 4% , P =0. 013). There was a significant difference in mean duration of mechanical ventilation between the 15 cases of early-onset VAP and 20 cases of late-onset VAP (17 15 days vs. 43 46 days, P =0. 042). Among the initially detected pathogen, Staphyloooccus aureus remains the most common Gram-positive coccus whereas Acinelobaeter Baumannii took the place of Pseudomonas aeruginosa as the top Gram-negalive rod. Conclusion Postoperative VAP after lung surgery has different clinical features from VAP in medical ICU.
中文关键词	肺炎 ; 手术后并发症 ; 肺外科手术 ; 呼吸,人工
英文关键词	Pneumonia Postoperative complications Pulmonary surgicalprocedures Respirationartificial
语种	中文
国家	中国
收录类别	CSCD
WOS类目	SURGERY
WOS研究方向	Surgery
CSCD记录号	CSCD:2436477
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/220549
作者单位	上海市肺科医院胸外科, 200433
推荐引用方式 GB/T 7714	王兴安,童稳圃,姜格宁,等. 肺外科术后呼吸机相关肺炎临床分析[J],2006,44(18):1225-1228.
APA	王兴安,童稳圃,姜格宁,丁嘉安,&周逸鸣.(2006).肺外科术后呼吸机相关肺炎临床分析.,44(18),1225-1228.
MLA	王兴安,et al."肺外科术后呼吸机相关肺炎临床分析".44.18(2006):1225-1228.