本文關(guān)鍵詞： 帕金森病 肺部感染 臨床漏診　出處：《中華醫(yī)院感染學(xué)雜志》2017年10期 　論文類型：期刊論文

【摘要】：目的探討帕金森病患者肺部感染臨床漏診原因,總結(jié)病原菌分布和耐藥情況,以期降低漏診和感染率。方法回顧性分析2011年1月-2013年1月86例帕金森病肺部感染患者,統(tǒng)計其病原菌分布和耐藥性,并對其中漏診的11例患者的漏診原因進(jìn)行總結(jié)。結(jié)果帕金森病肺部感染86例患者中共培養(yǎng)出病原菌107株,其中革蘭陰性菌72株,占67.29%,革蘭陽性菌35株,占32.71%;革蘭陰性菌中銅綠假單胞菌占28.97%、大腸埃希菌占17.76%、陰溝腸桿菌占12.15%;革蘭陽性菌中金黃色葡萄球菌占15.89%、肺炎鏈球菌占10.28%;革蘭陰性菌對亞胺培南、美羅培南耐藥率均為0,對其余抗菌藥物的耐藥率均52.63%;革蘭陽性菌對萬古霉素耐藥率為0,對其余抗菌藥物的耐藥率均72.73%;在帕金森病肺部感染漏診原因中以口服藥物影響最常見,占36.37%,其他的主要是停藥、用藥不足或減藥引起,占27.27%,誤吸占18.18%,醫(yī)師忽視占18.18%。結(jié)論帕金森病患者肺部感染病原菌較多,漏診率高,原因多為主觀性。
[Abstract]:Objective to investigate the causes of clinical missed diagnosis of pulmonary infection in patients with Parkinson's disease (PD) and to summarize the distribution of pathogenic bacteria and drug resistance. Methods from January 2011 to January 2013, 86 patients with pulmonary infection of Parkinson's disease were analyzed retrospectively. The causes of missed diagnosis in 11 patients with Parkinson's disease were summarized. Results A total of 107 strains of pathogenic bacteria were cultured in 86 patients with pulmonary infection of Parkinson's disease, of which 72 strains were Gram-negative bacteria (67.29% strains). 35 Gram-positive bacteria (32.71%); Pseudomonas aeruginosa accounted for 28.97, Escherichia coli 17.76 and Enterobacter cloacae 12.15. Among Gram-positive bacteria, Staphylococcus aureus accounted for 15.89%, Streptococcus pneumoniae 10.28%. The resistance rates of Gram-negative bacteria to imipenem and meropenem were 0 and 52.63 to other antimicrobial agents. The resistance rate of gram-positive bacteria to vancomycin was 0, and that to other antimicrobial agents was 72.73. Oral drugs are the most common cause of missed diagnosis of pulmonary infection in Parkinson's disease (36.37%). The rest are mainly caused by withdrawal of drugs, insufficient use or reduction of drugs, accounting for 27.27%, and 18.18%% by mistake. Conclusion Pulmonary infection in patients with Parkinson's disease has more pathogenic bacteria and high rate of missed diagnosis, which is mainly caused by subjectivity.
【作者單位】： 海南省中醫(yī)院神經(jīng)內(nèi)科;
【基金】：海南省中醫(yī)藥管理局基金資助項目(hn28123)
【分類號】：R563.1;R742.5
【正文快照】： 帕金森病是一種進(jìn)程緩慢的神經(jīng)系統(tǒng)變性疾病,晚期則由于肌強(qiáng)直和全身僵硬等臥床不起,加上該疾病好發(fā)于老年人,基礎(chǔ)疾病多,營養(yǎng)狀態(tài)差,免疫力差。帕金森病患者最大的問題是患者生活質(zhì)量嚴(yán)重下降,生活不能自理,由于神經(jīng)的退化,活動能力、思維能力受限,導(dǎo)致患者多種臟器功能受限,，

本文編號：1480825