绍兴地区重症肺炎患者临床特征及诱发因素分析

Clinical characteristics and predisposing factors of patients with severe pneumonia in Shaoxing

目的了解并分析绍兴地区重症肺炎患者临床特征及发病危险因素。方法回顾性分析2017-2019年于绍兴市柯桥区中医医院急诊科就诊的180例重症肺炎患者资料,分析重症肺炎临床特征。选取同期普通肺炎患者70例做为对照,Logistic回归分析发生重症肺炎的危险因素。结果重症肺炎患者男女比例2.40∶1,年龄(43.64±13.68)岁,死亡47例(26.11%)。多因素Logistic回归分析显示,年龄(OR=0.958,95%CI:0.931~0.987)、体质量指数(OR=0.757,95%CI:0.666~0.860)与重症肺炎的发生负相关,肺炎严重指数(OR=1.107,95%CI:1.072~1.143)、呼吸困难(OR=80.365,95%CI:33.091~195.175)、长期卧床(OR=7.674,95%CI:4.070~14.471)、接受过气管插管(OR=16.000,95%CI:8.024~31.906)、休克(OR=53.333,95%CI:21.168~134.376)和意识障碍(OR=2.571,95%CI:12.492~53.990)是发生重症肺炎的危险因素。结论绍兴地区重症肺炎患者男性居多,对存在呼吸困难、休克、意识障碍、接受过气管插管等的患者应及时干预避免重症肺炎的发生。

Objective To understand and analyze the clinical features and pathogenic factors of patients with severe pneumonia(SP)in Shaoxing.Methods Data of 180 SP patients in the Emergency Department of Shaoxing Keqiao District Chinese Medicine Hospital from 2017 to 2019 were retrospectively analyzed to understand the clinical features of SP.There were 70 patients with usual pneumonia at the same time selected as controls.Logistic regression analysis was carried out to analyzed the predisposing factors of SP.Results Among 180 SP patients,the male to female ratio was 2.40:1,and the age was(43.64±13.68)years old.A total of 47 cases(26.11%)died.Logistic regression analysis showed that age(OR=0.958,95%CI:0.931-0.987),body mass index(OR=0.757,95%CI:0.666-0.860)were negatively correlated with SP,pneumonia severity index(OR=1.107,95%CI:1.072-1.143),dyspnea(OR=80.365,95%CI:33.091-195.175),prolonged bed rest(OR=7.674,95%CI:4.070-14.471),endotracheal intubation(OR=16.000,95%CI:8.024-31.906),shock(OR=53.333,95%CI:21.168-134.376)and disturbance of consciousness(OR=2.571,95%CI:12.492-53.990)were risk factors for SP.Conclusions The majority of SP patients are males in Shaoxing.Patients suffering difficult breathing,shock,disturbance of consciousness and endotracheal intubation should be timely intervened to avoid the occurrence of SP.