老年吸入性肺炎的临床特点及诊治分析

Analysis of clinical characteristics,treatment and diagnosis of senile aspiration pneumonia

目的：探讨老年吸入性肺炎的临床特点、治疗方法及临床疗效。方法回顾性分析2009年5月至2013年5月收治的45例老年吸入性肺炎患者的临床资料，总结本病的临床特点及诊疗方法。结果45例患者中以意识改变、发热为主要表现者32例（73.3%）；21例应用 BiPAP 无创机械通气辅助呼吸；治疗3~6 d 后40例患者咳嗽、咳痰好转，呼吸困难改善，低氧血症得到纠正，复查胸片均显示肺部阴影吸收好转，3例效差，2例死于多脏器功能衰竭及严重感染。临床治愈13例，显效16例，好转11例，总有效率为88.9%。结论老年吸入性肺炎患者易反复发作，临床应早期选择敏感抗生素，应用大剂量盐酸氨溴索，重者辅以无创机械通气，同时积极治疗基础疾病，可提高治疗效果。

Objective To investigate the clinical characteristics,therapeutic methods and clini-cal effects of senile aspiration pneumonia. Methods A retrospective analysis was performed on the clini-cal data of 45 patients with senile aspiration pneumonia from May 2009 to May 2013,and the clinical characteristics and therapy methods were summarized. Results There were 32 cases（73. 3% ）had con-sciousness change and fever as the main forms of manifestation,21 cases had BiPAP to assiste respira-tion;40 patients improved in the symptoms of cough,cough up phlegm and dyspnea,the hyoxemia was also redressed 3 - 6 days after treated,when reviewed the rabat,that the shadow in the lung assimilated ability was improved. The rehabilitation efficacy was bad in 3 cases,2 cases died of multiple organ fail-ure and serious infection. Thirteen cases were cured,16 cases were markedly improved and 11 cases turned batter,the total effective rate was 88. 9% . Conclusions Senile aspiration pneumonia recurs eas-ily,sensitive antimicrobial agents should be given earlier,and large dose of ambroxol hydrochloride should be given,for severe patients should be assisted with mechanical ventilation on the basis of treating underlying disease positively,which can improve the treatment effect.