本文選題：重癥肺炎　切入點：年齡　出處：《廣西醫(yī)科大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的：了解不同年齡組重癥肺炎患者臨床特點,以期對不同年齡階段的重癥肺炎患者予個性化的診療提供理論參考。方法：對2012年6月至2014年6月在廣西醫(yī)科大學第一附屬醫(yī)院住院診斷為重癥肺炎的患者進行回顧性分析。對滿足納入標準的病例,按我國年齡分組分為青年組、中年組、老年組,并將各年齡組分出重癥社區(qū)獲得性肺炎組和重癥醫(yī)院獲得性肺炎組。收集其一般情況、基礎疾病、輔助通氣治療、病原學特點及其初始抗生素使用等行統(tǒng)計學分析。結果：按本研究納入標準,共納入81例重癥肺炎患者,其中男性51例,女性30例；按年齡分組：青年8例,中年30例,老年43例,平均年齡：63.51±16.13歲。81例患者中重癥社區(qū)獲得性肺炎49例,其死亡率為42.9%,重癥醫(yī)院獲得性肺炎32例,其死亡率為78%,兩者差異具有統(tǒng)計學意義(P0.05)。不同年齡組死亡率差異無統(tǒng)計學意義。老年組基礎疾病組成與中年組不同,其中高血壓、腦梗塞、冠心病、心律失常在老年組中發(fā)病率較中年組多,其差異具有統(tǒng)計學意義(P0.05)。中年組重癥社區(qū)獲得性肺炎患者經(jīng)無創(chuàng)呼吸機治療成功率高于老年組,其差異具有統(tǒng)計學意義(P0.05),老年組需氣管插管比率高且死亡率高。青年組病原學陽性率低,中、老年組病原學以革蘭氏陰性菌為主,鮑曼不動桿菌、銅綠假單胞菌多重耐藥情況突出。我院初始經(jīng)驗用藥常選用抗生素為：β內(nèi)酰胺類、喹諾酮類。結論：各年齡組死亡率均高,需注重各年齡階段的重癥肺炎的治療,老年組基礎疾病比例高,無創(chuàng)呼吸機的治療在中年組重癥社區(qū)獲得性肺炎的成功率高。重癥肺炎病原學以革蘭氏陰性菌為主,且鮑曼不動桿菌、銅綠假單胞菌耐藥率高。我院初始經(jīng)驗用藥常選用抗生素為：β內(nèi)酰胺類、喹諾酮類。
[Abstract]:Objective: to investigate the clinical characteristics of severe pneumonia in different age groups. Objective: to provide theoretical reference for individualized diagnosis and treatment of severe pneumonia patients of different ages. Methods: from June 2012 to June 2014, the patients diagnosed as severe pneumonia in the first affiliated Hospital of Guangxi Medical University were studied. Retrospective analysis. For cases that meet the inclusion criteria, According to the age of our country, they were divided into youth group, middle age group, old age group, and each age group was divided into severe community acquired pneumonia group and severe nosocomial pneumonia group. Results: according to the criteria of this study, 81 patients with severe pneumonia were included, including 51 males and 30 females. Among the 43 elderly patients, the average age was 63.51 鹵16.13 years old. Among them, 49 cases were severe community-acquired pneumonia, the mortality rate was 42.9%, and 32 cases were severe nosocomial pneumonia. The mortality rate was 78. The difference between the two groups was statistically significant (P 0.05). There was no significant difference in mortality among different age groups. The composition of basic diseases in the elderly group was different from that in the middle age group, including hypertension, cerebral infarction, coronary heart disease. The incidence of arrhythmia in the elderly group was higher than that in the middle-aged group, and the difference was statistically significant (P 0.05). The success rate of non-invasive ventilator treatment in the middle-aged group was higher than that in the elderly group. The difference was statistically significant (P 0.05), the rate of tracheal intubation was high and the mortality rate was high in the aged group, and the positive rate of etiology in the young group was low. In the middle and middle age group, Gram-negative bacteria was the main pathogen, Acinetobacter baumannii was the main pathogen. The multidrug resistance of Pseudomonas aeruginosa was prominent. In our hospital, antibiotics were often used as 尾 lactams and quinolones. Conclusion: the mortality rate of each age group is high, so we should pay attention to the treatment of severe pneumonia at all ages. In the elderly group, the proportion of basic diseases was high, and the success rate of non-invasive ventilator was high in the middle age group. The etiology of severe pneumonia was mainly Gram-negative bacteria and Acinetobacter baumannii. Pseudomonas aeruginosa resistance rate is high. In our hospital, antibiotics are 尾-lactams and quinolones.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R563.1

【參考文獻】

相關期刊論文 前5條

1 梁道業(yè);馬春林;莫紹春;林化;;老年重癥肺炎264例病原學結果分析[J];廣西中醫(yī)學院學報;2011年01期

2 葉超輝,成旭明;老年重癥肺炎的病原學及藥敏分析[J];臨床肺科雜志;2004年03期

3 賀蓓;周慶濤;;社區(qū)獲得性肺炎和醫(yī)院獲得性肺炎國外指南評析[J];中國實用內(nèi)科雜志;2009年04期

4 孫鐵英;;社區(qū)獲得性肺炎診治指南的變遷[J];中國實用內(nèi)科雜志;2009年07期

5 陳奕慧;林紅燕;付飛;史兆駒;林秀娟;;鮑曼不動桿菌分布特征及耐藥趨勢的臨床研究[J];中國現(xiàn)代醫(yī)藥雜志;2010年02期

，

本文編號：1622422