ICU老年患者肺部感染的临床特点与预防措施

Discussion on clinical characteristics and preventive measures of elderly patients with pulmonary infection in ICU

目的探讨ICU老年肺部感染患者的临床特点及高危因素,并分析预防措施,为临床治疗提供参考依据。方法分析2012年1月-2014年1月710例ICU老年患者临床资料,采用Kap-lan-Meier单因素分析与多因素logistic回归统计对导致ICU老年肺部感染的高危因素进行统计分析,采用SPSS14.0进行统计处理。结果 710例老年患者中发生肺部感染共73例,感染率为10.28%;主要临床表现主要为发热、咳嗽咳痰、肺部啰音;单因素分析提示,患者年龄(≥80岁)、两种以上基础疾病、进行侵入性操作等是导致ICU老年患者肺部感染的高危因素(P<0.05);其中,≥80岁与<80岁患者感染率分别为15.41%与5.80%;1种与≥2种基础疾病患者感染率分别为6.74%与15.71%;有与无侵入性操作患者感染率分别为14.71%与5.54%;多因素logistic回归统计提示,患者年龄>80岁、两种以上基础疾病、进行侵入性操作均为ICU老年患者肺部感染的独立高危因素(P<0.05)。结论患者年龄≥80岁、≥2种基础疾病、进行侵入性操作等是引发ICU老年患者肺部感染的高危因素,因此根据上述因素,制定合理的治疗措施显得格外重要。

OBJECTIVE To investigate the clinical features and risk factors of pulmonary infections in the senile patients in ICU and analyze the preventive measures so as to provide references for clinical treatments.METHODS The clinical data of 710 senile patients in ICU from Jan.2012 to Jan.2014 were included in the study.Kap-lanMeier single factor analysis and multi-factor logistic regression analysis were adopted to analyze the high risk factors that caused pulmonary infections in elderly patients in ICU.All data were statistically analyzed by SPSS 14.0software.RESULTS Totally 73 cases appeared pulmonary infections in the 701 cases of elderly patients with clinical manifestations of fever,cough,expectoration and rale in the lung and the infection rate was 10.28%.The single factor analysis showed that the age of the patients（≥80years）,more than two underlying disease,invasive operation were the risk factors for elderly patients with pulmonary infections in ICU（P〈0.05）.The infection rates of patients more than 80 years old and less than 80 were 15.41% and 5.80%.And the infection rates in patients with only one basic disease and more than 2kinds of underlying diseases were 6.74% and 15.71% respectively.When it came to whether treated with invasive operation,the infection rate was 14.71%and 5.54%.Multivariate logistic regression statistics suggested,the age of the patients（〉80years）,more than two kinds of basic diseases,and invasive operation were independent risk factors for senile patients with pulmonary infections in ICU（P〈0.05）.CONCLUSIONThe age of the patients（≥80years）,more than two underlying diseases,and invasive operation are high risk factors for pulmonary infections in elderly patients ICU.Therefore,making reasonable treatment measures according to the above factors is particularly important.