心功能不全合并肺部感染患者的临床分析

发布时间：2018-05-28 00:16

本文选题：心功能不全 + 肺部感染　；参考：《中华医院感染学杂志》2014年01期

【摘要】：目的研究心功能不全合并肺部感染的病原学特点,为临床提高心功能不全合并肺部感染的诊治水平提供参考。方法选取2010年10月-2012年10月入院治疗的心功能不全患者268例,对患者的痰液等呼吸道分泌物进行细菌培养和药敏试验,分析相关影响因素,对其进行病原学分析,并探讨相关的诊治对策,采用SPSS16.0进行统计分析。结果有基础疾病的患者发生感染215例,感染率为49.77%,无基础疾病的患者发生感染53例,感染率为20.75%;70岁患者感染率为49.32%、60～70岁患者为40.48%、50～60岁患者为45.45%,50岁患者为42.86%;268例患者做呼吸道分泌物培养378次,阳性302次,检出率79.89%,共检出病原菌408株,其中革兰阴性菌312株占76.47%,革兰阳性菌96株占23.53%;大肠埃希菌、肺炎克雷伯菌对头孢曲松、亚胺培南的敏感率90.0%,铜绿假单胞菌、肺炎链球菌对亚胺培南的敏感率约90.0%。结论心功能不全合并肺部感染的发生率随着年龄升高有增加的趋势;病原菌以革兰阴性菌为主,并且病原菌对常见抗菌药物的耐药现象较为严重,临床上应及时调整用药方针,尽早发现及预防感染。
[Abstract]:Objective to study the pathogenic characteristics of cardiac insufficiency combined with pulmonary infection, and to provide reference for clinical improvement of diagnosis and treatment of pulmonary infection in patients with cardiac insufficiency and pulmonary infection. Methods 268 patients with cardiac insufficiency were selected in October 2010 -2012 year in October, and the bacterial culture and drug sensitivity test of sputum and other respiratory secretions in the patients were analyzed. The related factors were analyzed, and the related etiological analysis was carried out, and the relevant diagnosis and treatment strategies were discussed and SPSS16.0 was used to carry out statistical analysis. The results showed that 215 cases of the patients with basic diseases were infected, the infection rate was 49.77%, 53 cases were infected without basic disease, the infection rate was 20.75%, the infection rate of 70 year old patients was 49.32%, the 60~70 year old patients were 40.48%, 50 The 60 year old patients were 45.45%, 50 years old were 42.86%, 268 cases were cultured 378 times with respiratory secretions, positive 302 times, the detection rate was 79.89%, and 408 strains were detected. Among them, 312 Gram-negative bacteria were 76.47%, Gram-positive bacteria accounted for 23.53%, and Escherichia coli, Klebsiella pneumoniae were sensitive to ceftriaxone and imipenem, and copper green. The susceptibility rate of Pseudomonas and Streptococcus pneumoniae to imipenem is about 90.0%. conclusion that the incidence of heart dysfunction combined with pulmonary infection increases with age. The pathogenic bacteria are mainly Gram-negative bacteria, and the drug resistance of pathogens to common antibiotics is more serious. The principle of drug use should be adjusted in time, and early detection should be found. And prevention of infection.
【作者单位】：南阳市中心医院心内二科;
【基金】：河南省卫生厅基金资助项目(200903127)
【分类号】：R563.1

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