80岁以上老年多种致病菌肺部感染合并多器官功能不全综合征的临床分析

Clinical analysis of pulmonary infection with multiple pathogenic bacteria complicated with multiple organ dysfunction syndrome in the patients aged over 80

目的探讨≥80岁老年多种致病菌肺部感染并发多器官功能不全综合征(MODSE)的现状和对策。方法对本院2005年8月至2009年8月32例≥80岁老年多种致病菌肺部感染并发MODSE患者的临床资料进行回顾性分析。结果 32例≥80岁老年多种致病菌肺部感染并发MODSE患者中,2种致病菌12例,3种致病菌16例,4种致病菌3例,5种致病菌1例。其中院内获得性肺炎占90.6%,社区获得性肺炎占9.4%,院内获得性肺炎主要致病菌以铜绿假单胞菌为主。病死率与累及的衰竭器官数和致病菌种数相关。结论≥80岁老年肺部感染并发MODSE患者常合并多种致病菌,早期控制感染、控制危险因素、给予营养支持和免疫治疗以提高抗病能力对阻止MODSE进展和改善预后有重要作用。

Objective To investigate the current situation and strategy of pulmonary infection with multiple pathogenic bacteria complicated by multiple organ dysfunction syndrome in the elderly（MODSE）.Methods Clinical data of 32 cases with pulmonary infection complicated by MODSE from August 2005 to August 2009 in our hospital were analyzed retrospectively.Results Among the 32 cases of patients,25 cases showed lung failure first,5 cases showed kidney fai-lure first,and 2 cases showed heart failure first;The main pathogenic bacteria was pseudomonas aeruginosa,stenotrophomonas maltophilia,staphylococcus aureus,baumanii,and so on.Hospital acquired pneumonia accounted for 90.6%,community-acquired pneumonia accounting for 9.4%.Mortality was related to the numerus of the number of organ failure and pathogenic bacteria.Conclusions Pathogenic infection in the elderly complicated with MODSE was often associated with multiple bacteria.The main pathogens of hospital acquired pneumonia were pseudomonas aeruginosa.The early control of infection and risk factors,nutritional support and immune therapy to improve disease resistance plays an important role in controlling MODSE and improving the prognosis.