心力衰竭患者合并肺部感染的临床特征观察

Clinical Analysis of Heart Failure Patients with Pulmonary Infection

目的:探讨心力衰竭患者合并肺部感染的特点。方法:分析220例心力衰竭患者临床资料,统计肺部感染发生率;观察其临床表现;比较肺部感染组(观察组)与无医院感染组(对照组)年龄、营养、心力衰竭程度、长期吸烟史、抗生素药物预防应用、吸痰气管插管等侵入性操作差异;痰液标本病原菌检测结果;治疗及预后。结果:心力衰竭患者220例发生肺部感染40例,占18.18%;具有典型表现者22例(55.00%),表现为心力衰竭加重、食欲不振、精神萎靡、倦怠不适等18例(45.00%);观察组年龄大于70岁65.00%、营养不良47.50%、心功能Ⅲ级45.00%、吸烟史40.00%、预防应用抗生素30.00%、侵入性操作22.50%,高于对照组的28.28%、33.33%、12.22%、22.22%、16.67%、8.89%,差异有统计学意义(P<0.05);痰液标本共检出病原菌66株,其中革兰阴性菌47株(71.21%),革兰阳性菌14株(21.21%),真菌5株(7.58%)。肺部感染患者死亡4例(10.00%)。结论:心力衰竭患者在住院期间受到多方面因素影响容易引发肺部感染,临床应提高警惕,加强对患者实施预防和治疗干预,减少肺部感染的发生。

Objective：To investigate the characteristics of pulmonary infection with heart failure.Method：Analysis of clinical data of 220 cases of heart failure patients,statistics the incidence of pulmonary infection,the clinical manifestation of pulmonary infection was observed.Age,nutrition,heart failure degree,smoking history,antibiotics prevention application,sputum suction of endotracheal intubation and invasive operation,difference detection of pathogens in sputum,results,treatment and prognosis in pulmonary infection group（the observation group） and no hospital infection group（the control group） were compared.Result：In patients with heart failure and 220 cases of pulmonary infection in 40 cases,accounting for 18.18%,22 cases with typical manifestations（55.00%）,for heart failure exacerbation,appetite promotion,listlessness,burnout discomfort in 18 cases（45.00%）,the observation group age older than 70 years was 65.00%,innutrition was 47.50%,heart function of malnutrition grade was 45.00%,smoking history was 40.00%,prophylactic use of antibiotics in 30.00%,invasive operation 22.50%,were higher than 28.28%,33.33%,12.22%,22.22%,16.67%,8.89% of the control group（P〈0.05）,sputum specimens of 66 pathogenic strains were detected,including 47 strains of gram negative bacteria（71.21%）,14 strains of gram positive bacteria（21.21%）,5 strains of fungi（7.58%）.4 patients died of pulmonary infection（10.00%）.Conclusion：Patients with heart failure during hospitalization are affected by many factors,easy to cause pulmonary infection,clinical shall be vigilant,strengthen the implementation of prevention and treatment of patients,reduce the incidence of pulmonary infection