华西医学

华西医学

国内外医院获得性肺炎和呼吸机相关性肺炎指南解析

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自2016年以来,美国、欧洲和我国分别就医院获得性肺炎(hospital-acquired pneumonia,HAP)/呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)的诊治指南进行了更新,该文对上述指南的主要观点和异同进行了总结。新的HAP/VAP指南中对于VAP的定义、评估抗菌药物治疗效果、预防仍存在争议,病原学获取方式、VAP的抗菌药物应用疗程仍是关注焦点,建议应用非侵入性呼吸道标本来判断病原学,对于VAP治疗不推荐长疗程抗菌药物方案。需要注意的是我国HAP病原学与国外不同,应引起我国临床医生重视,为我国临床实践提供有力的支持依据。

Since 2016, the guidelines for the management of adults with hospital-acquired pneumonia (HAP) / ventilator-associated pneumonia (VAP) have been updated in the United States, Europe, and China, respectively. The differences among these guidelines are demonstrated in this paper. The definition of VAP, how to evaluate the effect of anti-infection therapy, and the prevention strategy are controversial. The consensuses contain diagnostic value of respiratory secretions achieved by noninvasive way for VAP and shorter anti-infection course for VAP. Importantly, pathogenic spectrum for HAP in China is different from others, which is essential for clinical practice.

关键词: 医院获得性肺炎; 呼吸机相关性肺炎; 指南解析

Key words: Hospital-acquired pneumonia; Ventilator-associated pneumonia; Guideline interpretation

引用本文: 刘超, 曹彬. 国内外医院获得性肺炎和呼吸机相关性肺炎指南解析. 华西医学, 2019, 34(1): 7-11. doi: 10.7507/1002-0179.201711017 复制

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