老年患者下呼吸道感染原因分析及防治

Analysis of the Cause and Prevention of Nosocomial Infection with Lower Respiratory Tract in Elder Patients

目的:分析引起老年患者院内下呼吸道感染的原因,制定相应预防措施,以控制院内感染的发生,提高医疗安全。方法:通过病例查找,回顾性分析我院112例老年患者住院过程中发生院内下呼吸道感染的相关因素,包括发病时间、发病率、住院时间、基础疾病、治疗措施、病原菌分布等数据。结果:本组老年患者院内下呼吸道感染发生率为7.6%,明显高于同期院内感染发生率(1.6%);住院时间长(平均45±5.9 d);均有两种或两种以上基础疾病,其中以恶性肿瘤(53%)、慢性阻塞性肺病(48%)、脑血管疾病(43%)多见;均接授多种治疗措施,其中使用7天以上抗生素(53%)、雾化吸入(48%)、留置尿管(43%)、使用糖皮质激素(41%)为多;病原菌中以革兰阴性菌(54.0%)为主要致病菌,革兰阳性球菌(23.9%)、真菌(22.1%)、二重感染(19.0%)也常见。结论:老年患者容易发生院内下呼吸道感染,针对各种因素处理,可有效预防其发生。

Objective： To take precaution against noscominal infection by analyzing the causes of lower respiratory tract infection（LRTI） in elderly patients.Methods： The relevent factors of 112 patients with LRTI treated in our hospital were analyzed retrospectively,including duration of disease,morbility,hospital stays,underlying diseases,treatments,distribution of pathogens,etc.Results： The incidence of nosocomial LRTI was 7.6%,which was higher than the hospital infection rate（1.6%） in the same period and the hospital stays of the elderly group were longer（45±5.9 d in average）.All the cases in the elderly group have at least two underlying diseases,mostly with malignancy（53%）,COPD（48%）,cerebrovascular diseases（43%） and they have received different kinds of treatments,including more than 7 days＇ antibiotic treatment（53%）,atomization inhale（48%）,indwelling catheter（43%）,using glucocorticoid（41%）.The main pathogenic bacteria was Gram-negative bacteria（54%）,following Gram-positive cocci（23.9%）,fungus（22.1%）,double infection（19%）.Conclusions： The elderly patients were vulnerable to nosocomial LRTI.The precaution must be taken according to various factors.