高龄老人下呼吸道感染128例分析

Clinical analysis of 128 cases with lower respiratory infection in advanced age patients

目的 了解病房高龄老人 (>80岁 )下呼吸道感染的临床特点 ,病原菌和药敏情况。方法 回顾近 4年来我院病房中收治的高龄老人下呼吸道感染的临床资料 ,致病菌种和药敏结果。结果 12 8例病人均合并有两种以上基础疾病 ,院内感染约占一半 (6 0 / 12 8)。 98例完成了痰培养 ,共检出致病菌 15 1株 ,药敏结果提示对常用抗生素耐药率较高 ;合并真菌感染 36例。死亡率高达 35 .94 % (4 6 / 12 8)。结论 高龄老人全身情况差 ,合并多种疾病 ,感染机会多 ,对抗生素耐药率高。抗生素使用应针对老年人的病理生理特点 ,加强营养支持 ,加强对基础疾病的治疗 ,加强护理 ,可以提高治疗效果。

Objective To find out the clinical character and pathogenic bacteria and bacteriral susceptibility in the advanced age patients (Age>80) with lower respiratory infection in the department of medicine, in order to provide scientific evidence for the prevention and for the treatment. Methods Rretrospective analysis was performed on the clinical characteristics, pathogens and drug resistance in 128 cases with lower respiratory infection in the advanced age patients during January 2000 to December 2003. Results There were more than two diseases in every patient. Approximately half of these lower respiratory infection occurred in hospital. The clinical pictures were nonspecific. The samples of sputum were cultured in 98 cases and 151 organisms were present in these samples The pathogenic bacteria showed a high resistance to common antibiotics. Thirty-six patients had fungial infections. The mortality were high (35.94%).Conclusion The general condition of advanced age patients is very poor. There has been more than one primary disease in the group. The incidence rate of infection increases overtime. Resistance to antibiotics is higher. The choice of drug must be in accordance with pathophysiology of elderly patients. Emphasis should be given to the basic treatment of the primary disease, nutritional support and careful nursing.