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求呼吸器相關肺炎英文paper翻譯

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In ventilated patients, the normal defense system of the body, including the cilia in the nose and protective mucus, are circumvented, allowing the patient’s mouth to be colonized with pathogenic bacteria such as Pseudomonas, Acinetobacter, and Methicillin-resistant Staphylococcus aureus (MRSA) within 24 hours of admission to an ICU. Mechanically ventilated neurointensive care patients are at an increased risk for VAP due to factors such as decreased level of consciousness and inability to protect the airway.Neurologic patients with decreased level of consciousness or low Glasgow Coma Scale scores are prone to aspiration due to an unprotected airway and inability to swallow properly. Interventions for (ICP), such as raising the head of the bed, are a positive influence on prevention of VAP, whereas limited mobility because of ICP monitors, ventriculostomies, and disease processes such as spinal cord injury, can negatively affect VAP-prevention techniques.In addition, because it is difficult to temporarily stop sedation in neurologic patients who have increased ICP, the cessation of daily sedation cannot be used to prevent VAP in these patients. Other risk factors include gastric distension, presence of gastric or duodenal tubes, and trauma or chronic obstructive pulmonary disease.Meticulous mouth care is crucial for preventing VAP. Rincón-Ferrari and colleagues (2004) foundthat in head-injured patients, 40%–60% of the gram-negative bacilli found were due to endogenous lung colonization after aspiration of oropharyngeal secretions. Twenty percent to forty percent of these bacteria were Staphylococcus aureus, and more than half of the Staphylococcus aureus were methicillin-resistant. This type of staphylococcus is exogenous, usually originating from the hands.Studies have shown that patients can become colonized with pathogenic bacteria within 24 hours of admission to a critical care unit.

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  • 6 年前
    最佳解答

    在機械通氣病人的身體,包括鼻子和保護性黏液纖毛的正常防禦系統規避,允許病人的嘴裡,進入重症監護室的 24 小時內與致病細菌如金黃色銅綠假單胞菌、 不動桿菌和耐甲氧西林葡萄球菌 (MRSA) 殖民。機械通氣技術的研究進展護理患者呼吸機相關性肺炎危險因素增加如減少水準的意識和無力保護氣道。減少水準的意識或低格拉斯哥昏迷評分神經患者很容易由於得不到保護氣道和無法正常吞咽的願望。干預措施 (ICP),如提高的床上,頭都是預防 VAP,正面的影響,而有限的流動性,因為 icp 備顯示器,ventriculostomies 和脊髓損傷等疾病進程可以對呼吸機相關性肺炎防治技術產生負面影響。此外,因為很難暫時停止鎮靜神經功能增加了 ICP 的病人中,停止日常鎮靜不能用於防止 VAP 在這些患者中。其他的危險因素包括胃擴張、 胃或十二指腸管和外傷或慢性阻塞性肺疾病的存在。細緻的口腔護理是預防呼吸機相關性肺炎的關鍵。呂康法拉利和他的同事 (2004) 發現患者頭部受傷,發現的革蘭陰性桿菌的 40%60%是由於口咽部分泌物吸出後內源性肺殖民化。金黃色葡萄球菌,這些細菌的 20%到 40%,超過一半的金黃色葡萄球菌是耐甲氧西林。這種類型是葡萄球菌的外源性的通常源自手。研究顯示病人可以成為殖民與致病性細菌對危重病人護理單位入場的 24 小時內。

    2013-10-07 18:19:22 補充:

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    參考資料: me/internet
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