慢性充血性心力衰竭合并肺部感染临床特征分析  

Clinical Features of Chronic Congestive Heart Failure Complicating Pulmonary Infection

作　　者：王新鸣[1] 厉伟民[1] 李佳俊[2] 卢亮[1] 李国洪[1] 

机构地区：[1]温州医学院附属东阳医院心内科,浙江东阳322100 [2]温州医学院附属东阳医院细菌室,浙江东阳322100

出　　处：《中华医院感染学杂志》2010年第23期3691-3692,共2页Chinese Journal of Nosocomiology

摘　　要：目的探讨慢性充血性心力衰竭(CHF)合并肺部感染临床特征。方法回顾性分析180例CHF住院患者的临床资料。结果该组患者共发生肺部感染94例,占52.2%,入院前感染78例,占43.3%,医院感染16例,占8.9%;94例合并肺部感染的患者共分离出111株细菌,革兰阴性菌84株,占75.7%,革兰阳性菌27株,占24.3%;分布最多的3种细菌为铜绿假单胞菌(25.3%)、金黄色葡萄球菌(18.0%)和肺炎克雷伯菌(15.3%);主要细菌呈现出较高的耐药性;单因素分析显示,年龄≥60岁、住院时间≥30 d、侵入性操作、糖尿病和心功能Ⅲ、Ⅳ级为肺部感染的危险因素。结论 CHF合并肺部感染病以革兰阴性菌为主,应根据药敏试验选用合理的抗菌药物,同时应根据高危因素来控制和预防医院感染。OBJECTIVE To study the clinical features of congestive heart failure（CHF） complicated with pulmonary infection.METHODS 180 inpatients with CHF were retrospectively analyzed.RESULTS A total of 94 cases were pulmonary infected（52.2%）,78 cases of pre-hospital infection（43.3%）,16 cases of nosocomial infection（8.9%）.111 strains were isolated of which 84 strains were G-bacteria（75.7%）,and 27 strains were G＋ bacteria（24.3%）.The three main bacteria were Pseudomonas aeruginosa（25.3%）,Staphylococcus aureus（18.0%）,and Klebsiella pneumoniae（15.3%）.The main bacteria showed high drug resistance.Single factor analysis revealed that age（≥60 years old）,length of hospital stay（≥30 d）,virulence operation,diabetes and cardiac function classification（grade Ⅲ and Ⅳ） were the risk factors of pulmonary infection.CONCLUSION Congestive heart failure complicating pulmonary infection is mainly infected with gram-negative bacteria.The rational antibiotic should be chosen according to drug sensitive test,and nosocomial infection can be prevented and controlled by paying more attention to high risk factors.

关 键 词：慢性充血性心力衰竭 肺部感染 耐药性 

分 类 号：R181.3[医药卫生—流行病学]