慢阻肺合并睡眠呼吸暂停综合征老年患者肺感染的病原学及相关因素分析

发布时间：2018-04-08 09:16

本文选题：慢阻肺　切入点：睡眠呼吸暂停综合征　出处：《中华医院感染学杂志》2017年23期

【摘要】：目的探讨慢阻肺合并睡眠呼吸暂停综合征的老年患者发生肺感染的影响因素和病原菌状态,为临床实践提供依据。方法选取2015年12月-2016年10月期间医院收治呼吸内科和ICU病房的慢阻肺合并睡眠呼吸暂停综合征的老年患者654例为研究对象,对其肺部感染情况进行统计,对肺部感染患者的分泌物样本进行病原菌检测和药敏分析,采用单因素分析和多因素回归的分析方法统计分析导致患者发生肺感染的危险因素。结果654例患者中发生肺部感染的患者有163例,感染率为24.92%;163例肺部感染患者共检出病原菌198株,以革兰阴性菌为主,共132株占66.67%;肺炎克雷伯菌、铜绿假单胞菌和鲍氏不动杆菌对氨苄西林的耐药率较高,均90.00%;Logistic多元回归分析结果显示,年龄、住院时间、呼吸机微生物污染、心力衰竭、意识状态是慢阻肺合并睡眠呼吸暂停综合征老年患者肺感染的独立危险因素。结论慢阻肺合并睡眠呼吸暂停综合征的老年患者肺感染情况应给予高度重视,革兰阴性菌是导致感染的主要病原菌,年龄、住院时间、呼吸机微生物污染、心力衰竭、意识状态是慢阻肺合并睡眠呼吸暂停综合征老年患者肺感染的危险因素。
[Abstract]:Objective to investigate the influencing factors and pathogenic bacteria status of lung infection in elderly patients with COPD complicated with sleep apnea syndrome and to provide evidence for clinical practice.Methods from December 2015 to October 2016, 654 elderly patients with COPD complicated with sleep apnea syndrome (SPAS) admitted in our hospital from December 2015 to October 2016 were selected as subjects, and the pulmonary infection status was analyzed.The pathogenic bacteria and drug sensitivity were detected in the samples of patients with pulmonary infection, and the risk factors of pulmonary infection were analyzed by single factor analysis and multivariate regression analysis.Results there were 163 cases of pulmonary infection in 654 cases, and the infection rate was 24.922,163 cases of pulmonary infection. 198 strains of pathogenic bacteria were detected, mainly Gram-negative bacteria, 132 strains accounted for 66.67%, Klebsiella pneumoniae, Klebsiella pneumoniae, and Klebsiella pneumoniae.The resistance rate of Pseudomonas aeruginosa and Acinetobacter baumannii to ampicillin was higher. Logistic regression analysis showed that age, length of stay, microbial contamination by ventilator, heart failure, age, hospital stay, and heart failure were higher.Consciousness is an independent risk factor for lung infection in elderly patients with COPD complicated with sleep apnea syndrome.Conclusion the pulmonary infection in elderly patients with COPD complicated with sleep apnea syndrome should be paid more attention. Gram-negative bacteria are the main pathogens, age, length of stay in hospital, microorganism pollution of ventilator, heart failure.State of consciousness is a risk factor for lung infection in elderly patients with COPD complicated with sleep apnea syndrome.
【作者单位】：浙江医院重保门诊;浙江医院呼吸科;浙江医院重症医学科;浙江医院消化科;
【分类号】：R563.1;R563.9;R766

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