【摘要】：目的:調(diào)查本院急診科成人社區(qū)獲得性肺炎診療現(xiàn)況及病原學(xué)特點(diǎn),為本地區(qū)成人CAP治療提供參考。方法:納入2015年10月-2016年10月就診于我院急診科的住院成人CAP患者共124人,使用抗生素前留取痰培養(yǎng),記錄細(xì)菌培養(yǎng)、耐藥性結(jié)果,并完善患者基本情況,入院首次血液檢查結(jié)果,治療情況及預(yù)后等基線資料。統(tǒng)計(jì)學(xué)采用SPSS21.0軟件,計(jì)數(shù)資料采用X2檢驗(yàn)。結(jié)果:我院急診科就診的成人社區(qū)獲得性肺炎患者以老年患者為主,平均年齡65.37±16.688歲,男性患者多于女性患者,男女性別比為1.58:1。入院后93.5%的患者24小時(shí)內(nèi)得到抗感染治療,初始治療最常用的抗生素為β-內(nèi)酰胺類54.8%、呼吸喹諾酮類30.6%為主;124例患者中共48例(38.7%)痰培養(yǎng)培養(yǎng)出致病菌。培養(yǎng)前三位分別為肺炎克雷伯菌11例,肺炎鏈球菌9例,大腸埃希菌8例。肺炎克雷伯菌、肺炎鏈球菌均對(duì)β內(nèi)酰胺類、呼吸喹諾酮類及三代頭孢類抗生素敏感性高,對(duì)二代頭孢菌素敏感性低。結(jié)論:本院急診科住院的成人CAP患者以老年患者為主,肺部感染體征不明顯,常多伴隨各種基礎(chǔ)疾病,病原學(xué)構(gòu)成類似老年CAP致病菌譜分布,對(duì)β內(nèi)酰胺類、呼吸喹諾酮類敏感性較好。
[Abstract]:Objective: to investigate the diagnosis and treatment status and etiological characteristics of adult community-acquired pneumonia (CAP) in emergency department of our hospital. Methods: from October 2015 to October 2016, 124 adult CAP patients were admitted to our emergency department. Sputum culture was retained before antibiotic use, bacterial culture and drug resistance were recorded, and the basic conditions of the patients were improved. The results of first blood examination, treatment and prognosis were baseline data. SPSS21.0 software was used in statistics and X 2 test was used for counting data. Results: the majority of adult community-acquired pneumonia patients in our hospital were aged 65.37 鹵16.688 years old, male patients were more than female patients, the ratio of male to female was 1.58: 1. 93.5% of the patients received anti-infection treatment within 24 hours after admission. The most commonly used antibiotics in the initial treatment were 尾 -lactam 54.8and respiratory quinolones 30.6%, and there were 48 (38.7%) sputum cultures of pathogenic bacteria in 124 patients. The first three were Klebsiella pneumoniae (11 cases), Streptococcus pneumoniae (9 cases) and Escherichia coli (8 cases). Klebsiella pneumoniae and Streptococcus pneumoniae were highly sensitive to 尾 -lactam, respiratory quinolones and third-generation cephalosporins, but low to second-generation cephalosporins. Conclusion: adult CAP patients in the emergency department of our hospital are mainly elderly patients, pulmonary infection signs are not obvious, often accompanied by a variety of basic diseases, etiology is similar to the distribution of geriatric CAP pathogens, 尾 -lactam. The respiratory quinolones were sensitive.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R563.1

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