干休所高龄老年肺炎患者诊治回顾性分析

Experience of diagnosis and treatment of pneumonia in senior age cadres at the veterans-home

目的总结80岁以上高龄老年患者肺炎的临床特点和治疗效果。方法回顾分析近10年来2家干休所80例80岁以上高龄老年患者的临床资料。结果 80例患者中有34例以发热、咳嗽、咳痰、胸闷、呼吸困难等肺内症状为首发症状;46例以嗜睡、反应迟钝、乏力、食欲减退、恶心、呕吐、心动过速以及原有基础病恶化等肺外症状为首发症状,胸部X线或CT检查以单侧或双侧点片状、斑片状浸润影居多,病灶多分布在肺段以下,80例患者中治愈47例,好转26例,无效4例,死亡3例。结论 80岁以上高龄老年肺炎表现多样,不典型,多合并多种慢性基础病,治疗周期长,并发症多,死亡率高。早期诊疗及个性化治疗有利于提高治愈率,减少并发症,降低死亡率。

Objective To summarize the clinical features and treatment effect on senile pneumonia in senior age cadres. Methods A retrospective analysis was made on the clinical data of 80 senile pneumonia patients of the 2 veterans-homes in recent 10 years. Results Of the 80 patients, 34 had such initial pulmonary symptoms as fever, cough, expectoration, chest distress, dyspnea, etc. and 46 patients had initial symptoms of drowsiness, slow response, asthenia, anorexia, nausea, vomiting, tachycardia and further deterio- ration of primary diseases. Thoracic radiography or CT scanning showed that there were unilateral and bilateral dotted or patchy shadows in both lungs, and foci were mostly distributed below lung segments. Of the 80 patients, 47 were cured, 26 were improved, 4 were invalid and 3 died. Conclusion Symptoms of senile pneumonia in the patients of over 80 years were varied and untypical, and in most cases were complicated with chronic diseases, with features of long treatment course and many complications, and with a high rate of mortality. Early diagnosis, treatment and personalized therapy would help to increase the cure rate and decrease rate of complications and mortality.