高龄老年肺炎65例临床分析

Clinical analysis on 65 cases with advanced agegerontal pneumonica

目的探讨高龄老年肺炎的临床特点及诊治概况。方法分析2003年1月至2006年6月在我院住院的65例80岁以上高龄老年肺炎患者临床资料。结果既往有心、肺、神经系统等基础疾病者发病多。临床症状多表现为咳嗽(42例),咯痰(36例),喘息或呼吸困难(31例),中低热(25例),非特异症状多见,易出现并发症。X线胸片以小片状、斑点状阴影多见(42例);血气分析以低氧血症多见(40例),可出现呼吸衰竭(19例)。CAP及HAP两组痰培养以革兰阴性杆菌感染多见,HAP组真菌感染明显高于CAP组。结论高龄老年肺炎临床表现不典型且复杂,咳嗽、咯痰、喘息或呼吸困难、中低热是高龄老年肺炎的主要临床表现,高热、寒战、胸痛不明显,消化和神经系统的非特异症状多见。X线胸片、血气分析及痰培养等辅助检查对该病的及时诊治非常重要。重视基础疾病的治疗与全身情况的改善有助于提高临床治愈率、好转率。

Objective To inquire into the clinical characteristics and treatment of advanced agegerontal pneumonia.Methods The clinical data of 65 cases with advanced agesgerontal pneumonia whose age were over 80 years and stayed in our hospital from January 2003 to June 2006 was analyzed.Results The cases have the foundation diseases such as heart,lung and nervous system,etc are easy to fall ill.Clinical symptoms as follows:cough(42 cases),expectoration(36 cases),gasping or dyspnea(31 cases),middle or low fever(25 cases),and non-specific symptoms are frequent,also the complications.The X-ray sternite shows I fragm or mottling(42 cases)and blood gas analysis shows hypoxemia(40 cases),also appears respiratory failure(19 cases).The CAP and HAP sets's sputum culture can be seen much G-,fungous infection in HAP set is more than in CAP set.Conclusion The clinical manifestation of advanced agesgerontal pneumonia is atypical and multiplicity,and cough,expectoration,gasping or dyspnea,middle or low fever the clinical manifestations,but ardent fever,CFNS and chest complaint are not manifest.The non-specific of alimentary system and nervous system seen much.The auxiliary examinations,such as X-ray sternite,blood gas analysis and sputum culture,etc are very important to diagnose and treatment of advanced agesgerontal pneumonia.Treating foundation disease and improving sys.condition conduce to raise clinical improvement rate.