老年人医院获得性肺炎的调查分析

The Survey and Analysis on Hospital-Acquired Pneumonia in Elderly Patients

目的探讨老年人医院获得性肺炎的临床特点。方法临床观察患者,并进行病原学、实验室及影像学检查,明确诊断后进行临床分析。结果482例老年患者有39例发生了医院内获得性肺炎,感染率为8.09%,年龄≥70岁33例(84.62%),医院内获得性肺炎感染时间为5～90d,其中以发热、肺部啰音、咳嗽咳痰为主要表现且分别为71.97%、64.10%、58.97%;共分离致病菌株39株,其中以肺炎克雷白杆菌,铜绿假单胞菌居多分别为35.90%、25.64%;痊愈25例(64.10%),有效9例(23.08%),好转3例(7.69%),无效2例(5.13%)。结论老年人医院获得性肺炎的临床特点不典型,病原菌多为革兰性阴性杆菌,应加强对老年住院患者的病原学检查,使用广谱抗生素,提高治愈率,提高病人生存质量。

Objective To investigate clinical characteristics of the elderly hospital-acquired pneumonia. Methods Patients with clinical observation, and etiology, laboratory and imaging examination, the diagnosis were analysed. Results In 482 cases, 39 cases of elderly patients had the hospital-acquired pneumonia, the infection rate was 8.09%, aged ≥170 years were 33 cases （84.62%）, hospital-acquired pneumonia time for 5-90 days. The rates of fever, rale, cough expectoration as the main performance were 71.97%, 64.10%, 58.97% respectively. A total of 39 strains isolated pathogens, with Klebsiella pneumonia, pseudomonas aeruginosa majority were. 35.90%, 25.64%. Cure 25 cases（64.10%）, effective 9 cases（23.08%）, improved 3 cases（7.69%）, invalid 2 cases（5.13%）. Conclusion The elderly hospital-acquired pneumonia has atypical clinical features, more pathogens to gram-negative bacilli. We should strengthen pathogenic inspection, the use of broad-spectrum antibiotics of elderly patients, curative rate and improve quality of life.