老年吸入性肺炎76例临床分析

Clinical study on 76 elderly patients with aspiration pneumonia

目的探讨老年吸入性肺炎的临床特点,为其临床诊治提供依据。方法选择山东大学千佛山医院收治的76例老年吸入性肺炎患者,回顾性分析其合并基础疾病情况、临床表现、病原学检查及治疗、转归情况。结果绝大部分老年吸入性肺炎患者合并有基础疾病,其中合并神经系统疾病居首位,占65.79%(50/76);痰培养病原学检查前三位分别为为肺炎克雷伯菌(25.49%)、大肠埃希菌(12.75%)、铜绿假单胞菌(11.76%);本组最终死亡率为13.76%,死亡的患者均至少合并3种基础疾病。结论老年吸入性肺炎患者临床表现不具有典型性,宜采用降阶梯疗法并根据药敏结果应用抗生素治疗;对于合并3种以上基础疾病的老年患者,应给予积极治疗。

Objective To investigate the clinical features of elderly patients with aspiration pneumonia, to provide guidance for the diagnosis and treatment. Methods Totally 76 cases of elderly patients with aspiration pneumonia were stud- ied including their combined underlying diseases, clinical manifestations, etiology examination and treatment, outcome of the situation. Results Most elderly patients with aspiration pneumonia with basic diseases, the neurological diseases accounting for 65.79% （ 50/76 ） ; The top three pathogens were Klehsiella pneumoniae （ 25.49% ）, Escheriehia coli （12. 75% ）, Pseudomonas aeruginosa intracellular bacteria （11.76%） ;The final mortality rate was 13.76%, and the patients combined wih at least three basic diseases. Conclusions Elderly patients with aspiration pneumonia do not have the typical clinical features, we should implement the anti - infection treatment with de - escalation therapy and according to susceptibility ; The elderly patients combined three or more basic diseases should be given active treatment.