不同年龄组重症肺炎患者临床特征分析

发布时间：2018-03-17 00:38

本文选题：重症肺炎　切入点：年龄　出处：《广西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：了解不同年龄组重症肺炎患者临床特点,以期对不同年龄阶段的重症肺炎患者予个性化的诊疗提供理论参考。方法：对2012年6月至2014年6月在广西医科大学第一附属医院住院诊断为重症肺炎的患者进行回顾性分析。对满足纳入标准的病例,按我国年龄分组分为青年组、中年组、老年组,并将各年龄组分出重症社区获得性肺炎组和重症医院获得性肺炎组。收集其一般情况、基础疾病、辅助通气治疗、病原学特点及其初始抗生素使用等行统计学分析。结果：按本研究纳入标准,共纳入81例重症肺炎患者,其中男性51例,女性30例；按年龄分组：青年8例,中年30例,老年43例,平均年龄：63.51±16.13岁。81例患者中重症社区获得性肺炎49例,其死亡率为42.9%,重症医院获得性肺炎32例,其死亡率为78%,两者差异具有统计学意义(P0.05)。不同年龄组死亡率差异无统计学意义。老年组基础疾病组成与中年组不同,其中高血压、脑梗塞、冠心病、心律失常在老年组中发病率较中年组多,其差异具有统计学意义(P0.05)。中年组重症社区获得性肺炎患者经无创呼吸机治疗成功率高于老年组,其差异具有统计学意义(P0.05),老年组需气管插管比率高且死亡率高。青年组病原学阳性率低,中、老年组病原学以革兰氏阴性菌为主,鲍曼不动杆菌、铜绿假单胞菌多重耐药情况突出。我院初始经验用药常选用抗生素为：β内酰胺类、喹诺酮类。结论：各年龄组死亡率均高,需注重各年龄阶段的重症肺炎的治疗,老年组基础疾病比例高,无创呼吸机的治疗在中年组重症社区获得性肺炎的成功率高。重症肺炎病原学以革兰氏阴性菌为主,且鲍曼不动杆菌、铜绿假单胞菌耐药率高。我院初始经验用药常选用抗生素为：β内酰胺类、喹诺酮类。
[Abstract]:Objective: to investigate the clinical characteristics of severe pneumonia in different age groups. Objective: to provide theoretical reference for individualized diagnosis and treatment of severe pneumonia patients of different ages. Methods: from June 2012 to June 2014, the patients diagnosed as severe pneumonia in the first affiliated Hospital of Guangxi Medical University were studied. Retrospective analysis. For cases that meet the inclusion criteria, According to the age of our country, they were divided into youth group, middle age group, old age group, and each age group was divided into severe community acquired pneumonia group and severe nosocomial pneumonia group. Results: according to the criteria of this study, 81 patients with severe pneumonia were included, including 51 males and 30 females. Among the 43 elderly patients, the average age was 63.51 卤16.13 years old. Among them, 49 cases were severe community-acquired pneumonia, the mortality rate was 42.9%, and 32 cases were severe nosocomial pneumonia. The mortality rate was 78. The difference between the two groups was statistically significant (P 0.05). There was no significant difference in mortality among different age groups. The composition of basic diseases in the elderly group was different from that in the middle age group, including hypertension, cerebral infarction, coronary heart disease. The incidence of arrhythmia in the elderly group was higher than that in the middle-aged group, and the difference was statistically significant (P 0.05). The success rate of non-invasive ventilator treatment in the middle-aged group was higher than that in the elderly group. The difference was statistically significant (P 0.05), the rate of tracheal intubation was high and the mortality rate was high in the aged group, and the positive rate of etiology in the young group was low. In the middle and middle age group, Gram-negative bacteria was the main pathogen, Acinetobacter baumannii was the main pathogen. The multidrug resistance of Pseudomonas aeruginosa was prominent. In our hospital, antibiotics were often used as 尾 lactams and quinolones. Conclusion: the mortality rate of each age group is high, so we should pay attention to the treatment of severe pneumonia at all ages. In the elderly group, the proportion of basic diseases was high, and the success rate of non-invasive ventilator was high in the middle age group. The etiology of severe pneumonia was mainly Gram-negative bacteria and Acinetobacter baumannii. Pseudomonas aeruginosa resistance rate is high. In our hospital, antibiotics are 尾-lactams and quinolones.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R563.1

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