心力衰竭住院患者合并肺部感染的调查分析

Investigation and analysis of pulmonary infections in heart failure patients

目的探讨心力衰竭住院患者合并肺部感染的临床特点。方法以760例心力衰竭患者作为研究对象,根据肺部感染诊断确立肺部感染病例;观察痰培养结果、分析肺部感染的影响因素,探讨肺部感染对预后的影响。结果合并肺部感染80例,感染率10.52%,表现呼吸系统症状54例,症状不典型26例;痰培养分离出病原菌60株:铜绿假单胞菌18株、肺炎克雷伯菌12株、大肠埃希菌7株、真菌13株;年龄大、心功能Ⅲ～Ⅳ级、机械通气比例高、预防应用抗菌药物、住院时间长是肺部感染的危险因素;肺部感染患者的死亡率为13.75%,高于无肺部感染组的3.26%。结论心力衰竭住院患者发生肺部感染较高,症状常不典型,影响因素复杂,应采取相应措施减少或避免肺部感染的发生。

OBJECTIVE To explore the clinical characteristics of pulmonary infections in heart failure patients. METHODS A total of 760 heart failure patients were assigned as the research objects, pulmonary infection cases were determined based on the diagnosis of pulmonary infections the results of sputum culture were observed, the influencing factors for pulmonary infections were analyzed, the influence of pulmonary infections on prognosis was explored. RESULTS There were 80 cases combined with pulmonary infections with the infection rate of 10.52 %, in which 54 eases manifested as respiratory system symptoms and 26 cases with atypical symptoms. Totally 60 strains of pathogens were isolated from sputum, including 18 Pseudomonas aeruginosa isolates, 12 Klebsiella pneumonia isolates,7 Escherichia coli isolates, and 13 fungi isolates. The advanced age, l]I -IV level of cardiac function, high mechanical ventilation, prophylactic antibiotics, and long hospital stay were the risk factors for pulmonary infections. The mortality rate of the patients with pulmonary infections was 13. 75%, which was higher than the patients without pulmonary infections （3.26%）. CONCLUSION Pulmonary infections frequently occur in the patients with heart failure and the symptoms are usually atypical, the influencing factors are complicated, so it is necessary to take corresponding measures to reduce or avoid pulmonary infections.