【摘要】：目的研究高齡醫(yī)療保健相關(guān)性肺炎(HCAP)患者的臨床特征、病原學(xué)特點(diǎn)與預(yù)后。方法對(duì)該院2012年4月至2015年4月收治的40例高齡HCAP患者的臨床資料進(jìn)行回顧性分析。結(jié)果 HCAP組患者的年齡、肺炎嚴(yán)重指數(shù)(PSI)評(píng)分、心血管疾病、慢性肺部疾病、慢性腎臟疾病、腫瘤、至少2種并發(fā)癥發(fā)生率均顯著高于社區(qū)獲得性肺炎(CAP)組,銅綠假單胞菌、金黃色葡萄球菌、多耐藥菌比例均顯著高于CAP組,肺炎鏈球菌比例顯著低于CAP組,單一抗生素比例顯著低于CAP組,更換抗生素、初始治療失敗、需要機(jī)械通氣、轉(zhuǎn)入重癥監(jiān)護(hù)室、1個(gè)月內(nèi)院內(nèi)死亡比例均顯著高于CAP組,住院時(shí)間顯著長(zhǎng)于CAP組(均P0.05)。結(jié)論高齡HCAP患者具有較大的年齡、較多的基礎(chǔ)疾病、較為嚴(yán)重的病情、較高的死亡率,革蘭陰性菌是主要病原菌,預(yù)后較差。
[Abstract]:Objective to study the clinical characteristics, etiological characteristics and prognosis of elderly patients with (HCAP). Methods the clinical data of 40 elderly patients with HCAP from April 2012 to April 2015 were analyzed retrospectively. Results the age, pneumonia severity index (PSI) score, cardiovascular disease, chronic lung disease, chronic kidney disease, tumor and at least two kinds of complications in HCAP group were significantly higher than those in community acquired pneumonia (CAP) group, Pseudomonas aeruginosa, Staphylococcus aureus and multi-drug resistant bacteria group, the proportion of Streptococcus pneumoniae was significantly lower than that in CAP group, and the proportion of single antibiotic was significantly lower than that in CAP group. Replacement of antibiotics, failure of initial treatment, need of mechanical ventilation, transfer to intensive care unit, the proportion of hospital death in one month was significantly higher than that in CAP group, and the hospitalization time was significantly longer than that in CAP group (P 0.05). Conclusion the elderly patients with HCAP have older age, more basic diseases, more serious diseases and higher mortality. Gram-negative bacteria are the main pathogenic bacteria and the prognosis is poor.
【作者單位】： 上海市崇明縣第二人民醫(yī)院呼吸科;
【基金】：上海交通大學(xué)科技基金項(xiàng)目(12xj22020)
【分類(lèi)號(hào)】：R563.1

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本文編號(hào)：2511737