PT -期刊文章AU -托雷斯,非盟- El-Ebiary M盟——太阳系,N盟——作品,C AU -法布雷加斯,N AU -埃尔南德斯,C TI -胃的机械通气期间呼吸道的殖民:与机械通气相关肺炎与DP - 1996年8月01 TA -欧洲呼吸杂志》第六PG - 1729 - 1735 - 9 IP - 8 4099 - //www.qdcxjkg.com/content/9/8/1729.short 4100 - //www.qdcxjkg.com/content/9/8/1729.full所以欧元和J1996 8月01;9 AB -呼吸机相关肺炎(VAP)的病因需要异常口咽和胃定植，并进一步将其内容物吸入下气道。人工气道患者如果吸入或接种微生物，其机械、细胞和/或体液防御发生改变，容易发生VAP。众所周知的胃定植的危险因素包括:胃液分泌的改变;胃内容物碱化;肠内营养管理;还有胆红素的存在。然而，定殖胃储层在VAP发展中的作用仍有争议。支持胃在VAP发展中的作用的证据主要来自于在重症监护室(ICU)进行的选择性肠道去污和应激性溃疡预防的随机对照试验，在这些试验中，减少胃的细菌负担可以降低医院呼吸道感染的发生率。然而，至少有三项关于菌群的研究发现，在机械通气过程中，没有胃源性肺炎发生。 Prophylactic measures suggested to prevent VAP in relation to the gastric reservoir include: treatment for stress ulcers with sucralfate; prevention of duodenal reflux with metoclopramide; reduction of gastric burden and bacterial translocation by selective digestive decontamination; acidification of enteral feeding; and jejunal feeding. Gastro-oesophageal reflux can be prevented by using small bore nasogastric tubes and jejunal feeding. The aspiration of gastric contents can be reduced by positioning patients in a semirecumbent position, checking the patency of the tube cuff, and aspiration of subglottic secretions. The role of the stomach as a reservoir for microorganisms causing ventilator-associated pneumonia is still controversial but despite the debate, there is major evidence in the literature in favour of the gastric origin of part of these pulmonary infections.