90岁以上老老年肺炎60例临床分析

Clinical Analysis of 60 Patients with Pneumonia Over 90-year-old

目的:通过与65岁以下成年肺炎进行比较,研究老老年肺炎患者临床特点。方法:比较2007年1月～2009年8月收治的90岁以上老老年肺炎患者(观察组)60例及同期18～64岁肺炎患者(对照组)60例的临床特点及短期预后。结果:与对照组相比,观察组意识障碍发生率高、体温低、电解质失衡发生率高特别是低钠血症、白蛋白低、累及多个肺叶发生率高、合并基础疾病和多器官功能不全多、PaCO_2高、死亡率高,P均<0.05。结论:老老年肺炎预后较差,早期足量抗感染治疗原发病,及时适当补充营养,可在一定程度上改善老老年肺炎患者预后。

Objective：To explore the characteristic of the oldest old pneumonia through comparison with adult pneumonia under 65 years. Methods： The clinical feature and short-term prognosis were compared between 60 patients with oldest old pneumonia over 90-year-old （observation group） and 60 patients with below 64-year-old adult pneumonia （ control group） prospectively. Results ： The incidence rate of conscious disturbance, lower body temperature, electrolytes disturbance especially hyponatremia, lower serum albumin, multi-lobar infection, underlying disease, more organ dysfunction, higher PaCO2 and higher mortality in observation group were significantly higher than those in control group, all P〈0.05. Conclusion： Prevention should be given priority for oldest old pneumonia because of the poor prognosis.Early-starting and enough-dosage administration of antibiotics, appropriate nutrition supplement may improve the prognosis of the oldest old pneumonia.