高龄老人社区获得性肺炎临床分析  

Clinic analysis of community-acquired pneumonia among the senile patients

作　　者：董宏艳[1] 亓鹏[1] 韦丽青[1] 王斌[1] 李丽[1] 陈丁丁[1] 郭靖[1] 

机构地区：[1]解放军第306医院干部病房,北京100101

出　　处：《中华保健医学杂志》2009年第5期346-348,共3页Chinese Journal of Health Care and Medicine

摘　　要：目的了解高龄老年人社区获得性肺炎(CAP)临床特点。方法收集2002年1月～2007年12月入住解放军第306医院80岁以上高龄CAP患者112例的临床资料,分析其临床特点、病原菌分布和耐药情况。结果高龄CAP患者的临床表现为:咳嗽75.9%、呼吸困难70.5%、神志改变67.9%、乏力62.5%、厌食50.0%、低血压40.2%;胸片斑片阴影累及多叶,且有肺间质改变;痰细菌分离率为71.3%,以革兰阴性杆菌为主,占59.3%,主要是铜绿假单胞菌、肺炎克雷伯菌、大肠杆菌;革兰阳性菌占36.8%;真菌占3.9%。铜绿假单胞菌对亚胺培南的耐药率最低,为20.0%,对头孢他啶、头孢哌酮/舒巴坦的耐药率分别为24.8%、27.9%,而对头孢曲松、头孢噻肟和头孢吡肟的耐药率分别为80.7%、78.6%和60.8%。结论高龄CAP患者临床症状和胸部X线征象不典型;病原菌以革兰阴性杆菌为主,治疗应根据药敏结果合理用药。Objective To analyze the clinical feature of community-acquired pneumonia （CAP）among the senile patients. Methods Collecting 112 cases of clinical data about senile patients with community-acquired pneumonia in January 2002 - December 2007. Clinical features ,distribution of Pathogenic bacteria and the resistance rate of drug were analysed. Results The clinical feature in community-acquired pnetmonia （CAP） among the senile patients is cough （75.9%）, dyspnea （70.5%）, consciousness change （67.9%）, acratia （ 62.5 % ）, anorexia （ 50.0% ）, hypotension （40.2%）. There are many patch shadow in many leaf and interstitial lung changes. Isolation rate of sputum specimens is 71.3%. Gram-negative bacilli including Pseudomonas aeruginosa,Klebsiella pneumoniae and Enterobacter is common,about 59.3% ;Gram-positive bacteria is 36.8%;fungi is 3.9%. The resistance rate of Pseudomonas aeruginosa to imipenem is minimum,less 20% ,to Ceftazidime is 24.8% ,to Cefoperazone and Sulbactam is 27.9% ,to Ceftriaxohe is 80.7%,to Cefotaxime is 78.6% ,to Cefepime is 60.8%. Conclusions The clinical feature and roentgen feature are not typical symptoms among the senile patients with community-acquired pneumonia. Gram-negative bacilli is common in Pathogenic bacteria.The patients should be treated according to the resistance rate of drug.

关 键 词：肺炎 老年人 社区获得性 

分 类 号：R563.1[医药卫生—呼吸系统]