随着机械通气技术的广泛应用，呼吸机相关性肺炎的发生率也随之上升。呼吸机相关性肺炎的发生不仅增加治疗难度、延长住院时间、增加患者痛苦，还可致患者死亡。因此，预防VAP是医院感染控制的重点环节。

插管48h后胸部X线影像可见新发生的或进展性的浸润阴影，同 时存在2种以上症状（体温＞38℃或＜36℃，外周血白细胞计数＞10×109/L 或＜4×109/L，气管、支气管内出现脓性分泌物），需排除肺水肿、急性呼吸窘迫综合征、肺结核、肺栓塞等情况。

VAP重点环节的防控建议共包括12个方面，本期我们介绍后6个方面，小伙伴们注意查看！

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inline-block;width: 100%;border-width: 2px;border-style: dotted;border-color: rgb(205, 224, 250);padding: 10px;box-sizing: border-box;"><section style="margin: 0px;box-sizing: border-box;"><section style="color: rgb(62, 62, 62);font-size: 14px;text-align: justify;letter-spacing: 1px;line-height: 2;box-sizing: border-box;"><p style="text-indent: 2.1333em;white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">VAP的发生率是评价护理质量的敏感指标之一，VAP的发生会导致患者平均住院时间延长、 住院费用增加、患者病死率上升。医护人员严格按照VAP防控相关护理工作制度执行专业化的操作规程，可以有效降低VAP的发生率。</p></section></section></section></section><section style="margin-top: 10px;margin-bottom: 10px;box-sizing: border-box;"><section style="display: inline-block;width: 100%;border-width: 2px;border-style: dotted;border-color: rgb(98, 164, 235);padding: 10px;box-sizing: border-box;"><section style="margin: 0px;box-sizing: border-box;"><section style="color: rgb(62, 62, 62);font-size: 15px;text-align: justify;letter-spacing: 1px;line-height: 2;box-sizing: border-box;"><p style="text-indent: 2.1333em;white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><span style="font-size: 14px;box-sizing: border-box;">本文通过对VAP防控**护理实践进行解读，希望能为临床护理人员制订、实施VAP的防控措施提供参考依据，以期降低临床VAP的发生率，从而提高临床护理质量。</span><br style="box-sizing: border-box;" /></p></section></section></section></section><section style="text-align: right;margin: -30px 0px 0px;line-height: 0;transform: translate3d(-10px, 0px, 0px);-webkit-transform: translate3d(-10px, 0px, 0px);-moz-transform: translate3d(-10px, 0px, 0px);-o-transform: translate3d(-10px, 0px, 0px);box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;width: 10%;height: auto;box-sizing: border-box;"><svg xmlns="http://www.w3.org/2000/svg" x="0px" y="0px" viewbox="0 0 163.9 174.3" style="box-sizing: border-box;" width="100%"><g style="box-sizing: border-box;"><g style="box-sizing: border-box;"><path style="box-sizing: border-box;" 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c1.1-0.9,2-1.9,3.1-2.9c0.8-0.8,1.5-1.6,2.2-2.4C140.8,61.7,140.3,60.9,139.9,60.2z" fill="rgb(255, 64, 68)"></path></g><g style="box-sizing: border-box;"><path style="box-sizing: border-box;" d="M160.9,111.2c-0.2-0.7-0.3-1.5-0.5-2.2c-0.6,0.4-1.3,0.9-1.9,1.3c-1.9,1.1-3.7,2.3-5.7,3.3 l-2.9,1.5l-3,1.3l-3,1.3l-3.1,1.2l-3.1,1.1c-1,0.4-2.1,0.7-3.1,1c-2.1,0.6-4.2,1.3-6.3,1.9l-6.4,1.6c-4.2,1.1-8.6,1.7-13,2.4 l-6.6,0.7c-1.1,0.1-2.2,0.3-3.3,0.4c-1.1,0.2-2.2,0.3-3.3,0.4c-0.9,0.1-1.7,0.2-2.6,0.4c-0.1,7.3,0,13,0.2,15.9 c1.9-0.4,3.8-0.9,5.7-1.4c4.4-1.3,8.7-3.1,13-4.7l6.4-2.7c2.1-0.9,4.3-1.7,6.4-2.6l6.3-2.8c2.1-1,4.1-2.1,6.2-3.1 c1-0.5,2.1-1,3-1.6l3-1.7l3-1.7l2.9-1.9l2.9-1.9l2.7-2.1c1.9-1.3,3.6-2.9,5.3-4.3C160.2,111.9,160.5,111.6,160.9,111.2z" fill="rgb(255, 64, 68)"></path></g><g style="box-sizing: border-box;"><path style="box-sizing: border-box;" d="M119.3,29.5c10.1,11.6,59.2,81.1,40.4,130.6c-8.6,15.2-10.7,17.4-24,10.3S94.8,158,93.4,146.1 S94.3,0.8,119.3,29.5z" fill="none"></path></g></g></svg></section></section><section style="text-align: justify;box-sizing: border-box;"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;" /></p></section><section style="margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"><img src="https://mmbiz.qpic.cn/sz_mmbiz_jpg/FSO2qhS5vT0xtxEE6ibicyU4y1ZrzjzkNFEiax4cjIMxczDWGLe8bjh9yQ9wqBvXic2hCtLia7fibialazPOBIpfDONGg/640?wx_fmt=jpeg" class="rich_pages wxw-img" data-ratio="0.29629" data-s="300,640" data-src="https://mmbiz.qpic.cn/sz_mmbiz_jpg/FSO2qhS5vT0xtxEE6ibicyU4y1ZrzjzkNFEiax4cjIMxczDWGLe8bjh9yQ9wqBvXic2hCtLia7fibialazPOBIpfDONGg/640?wx_fmt=jpeg" data-w="1080" style="vertical-align: middle;max-width: 100%;width: 100%;box-sizing: border-box;" width="100%" /></section></section></section></section><section style="margin: 40px 0px -8px;transform: translate3d(65px, 0px, 0px);-webkit-transform: translate3d(65px, 0px, 0px);-moz-transform: translate3d(65px, 0px, 0px);-o-transform: translate3d(65px, 0px, 0px);box-sizing: border-box;"><section style="text-align: center;font-size: 22px;color: rgb(205, 224, 250);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">LEARN</strong></p></section></section><section style="display: flex;width: 100%;flex-flow: column;box-sizing: border-box;"><section style="z-index: 2;box-sizing: border-box;"><section style="text-align: center;justify-content: center;display: flex;flex-flow: row;margin: 0px 0px 15px;box-sizing: border-box;"><section style="display: inline-block;vertical-align: top;width: auto;align-self: stretch;flex: 0 0 auto;min-width: 5%;max-width: 100%;height: auto;background-color: rgb(9, 46, 137);padding: 4px 8px;box-sizing: border-box;"><section style="text-align: justify;color: rgb(255, 255, 255);letter-spacing: 1px;box-sizing: border-box;"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">03</strong></p></section></section><section style="display: inline-block;vertical-align: top;width: auto;align-self: flex-start;flex: 0 0 auto;background-color: rgb(205, 224, 250);min-width: 5%;max-width: 100%;height: auto;padding: 4px 15px;box-sizing: border-box;"><section style="text-align: justify;color: rgb(9, 46, 137);letter-spacing: 1px;box-sizing: border-box;"><p style="text-align: center;white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">参考文献</strong></p></section></section></section></section></section><section style="text-align: center;justify-content: center;display: flex;flex-flow: row;box-sizing: border-box;"><section style="display: inline-block;width: 90%;vertical-align: top;align-self: flex-start;flex: 0 0 auto;background-color: rgb(255, 255, 255);box-shadow: rgb(205, 224, 250) 4px 4px 0px 0px;height: auto;padding: 20px;box-sizing: border-box;"><section style="margin: 0px;box-sizing: border-box;"><section style="text-align: justify;font-size: 12px;line-height: 2;letter-spacing: 1px;box-sizing: border-box;"><p style="text-indent: 0em;white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">[1]蔡虻,高凤莉.导管相关感染防控**护理实践专家共识[M].人民卫生出版社,2018.</p><p style="text-indent: 0em;white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">[2]彭飞.呼吸机相关性肺炎防控**护理实践——《导管相关感染防控**护理实践专家共识》系列解读之三[J].上海护理, 2020, 20(6):4.</p><p style="text-indent: 0em;white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">[3]血管导管相关感染预防与控制指南(2021版)[J].传染病信息, 2021, 34(4):3.&nbsp;</p></section></section></section></section><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;" /></p><section style="font-size: 14px;padding: 0px 30px;box-sizing: border-box;"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">资料来源：护理科研与循证小组</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">文字：孟娜 种婷婷</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">排版：孔令琪</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">初审：刘英慧</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">终审：荣宁宁</p></section><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;" /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;" /></p><section style="margin: 10px 0%;text-align: left;justify-content: flex-start;display: flex;flex-flow: row;box-sizing: border-box;"><section style="display: inline-block;width: 100%;vertical-align: top;border-width: 1px;border-style: solid none;border-color: rgb(126, 153, 92);margin: 0px;align-self: flex-start;flex: 0 0 auto;box-sizing: border-box;"><section style="margin: 3px 0% 0px;box-sizing: border-box;"><section style="background-color: rgba(153, 164, 118, 0.28);height: 1px;box-sizing: border-box;"><svg viewbox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section><section style="text-align: center;justify-content: center;display: flex;flex-flow: row;margin: 3px 0% 5px;box-sizing: border-box;"><section style="display: inline-block;vertical-align: middle;width: auto;align-self: center;min-width: 10%;max-width: 100%;flex: 0 0 auto;height: auto;box-sizing: border-box;"><section style="padding: 0px 2px;font-size: 17px;color: rgb(75, 86, 59);box-sizing: border-box;"><p style="text-align: right;margin: 0px;padding: 0px;box-sizing: border-box;">期待你的</p></section></section><section style="display: inline-block;vertical-align: middle;width: auto;min-width: 10%;max-width: 100%;flex: 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