高龄医疗保健相关性肺炎患者的临床特征、病原学特点及预后

发布时间：2019-07-08 16:55

【摘要】：目的研究高龄医疗保健相关性肺炎(HCAP)患者的临床特征、病原学特点与预后。方法对该院2012年4月至2015年4月收治的40例高龄HCAP患者的临床资料进行回顾性分析。结果 HCAP组患者的年龄、肺炎严重指数(PSI)评分、心血管疾病、慢性肺部疾病、慢性肾脏疾病、肿瘤、至少2种并发症发生率均显著高于社区获得性肺炎(CAP)组,铜绿假单胞菌、金黄色葡萄球菌、多耐药菌比例均显著高于CAP组,肺炎链球菌比例显著低于CAP组,单一抗生素比例显著低于CAP组,更换抗生素、初始治疗失败、需要机械通气、转入重症监护室、1个月内院内死亡比例均显著高于CAP组,住院时间显著长于CAP组(均P0.05)。结论高龄HCAP患者具有较大的年龄、较多的基础疾病、较为严重的病情、较高的死亡率,革兰阴性菌是主要病原菌,预后较差。
[Abstract]:Objective to study the clinical characteristics, etiological characteristics and prognosis of elderly patients with (HCAP). Methods the clinical data of 40 elderly patients with HCAP from April 2012 to April 2015 were analyzed retrospectively. Results the age, pneumonia severity index (PSI) score, cardiovascular disease, chronic lung disease, chronic kidney disease, tumor and at least two kinds of complications in HCAP group were significantly higher than those in community acquired pneumonia (CAP) group, Pseudomonas aeruginosa, Staphylococcus aureus and multi-drug resistant bacteria group, the proportion of Streptococcus pneumoniae was significantly lower than that in CAP group, and the proportion of single antibiotic was significantly lower than that in CAP group. Replacement of antibiotics, failure of initial treatment, need of mechanical ventilation, transfer to intensive care unit, the proportion of hospital death in one month was significantly higher than that in CAP group, and the hospitalization time was significantly longer than that in CAP group (P 0.05). Conclusion the elderly patients with HCAP have older age, more basic diseases, more serious diseases and higher mortality. Gram-negative bacteria are the main pathogenic bacteria and the prognosis is poor.
【作者单位】：上海市崇明县第二人民医院呼吸科;
【基金】：上海交通大学科技基金项目(12xj22020)
【分类号】：R563.1

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