老年卒中相关性肺炎患者病原学分析  

Analysis on etiology of elderly patients with stroke associated pneumonia

作　　者：戴莉莉[1] 张翀[1] 金烨[1] 沈斌[1] 刘炎[1] 

机构地区：[1]上海市第二人民医院,上海200011

出　　处：《临床肺科杂志》2011年第7期1040-1042,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨老年卒中相关性肺炎的病原学特征。方法收集2005年10月～2010年6月呼吸科住院的230例老年患者卒中后细菌性吸入性肺炎病例,统计并分析其病原学特点。结果卒中后细菌性吸入性肺炎临床表现不典型,诊断较为困难,共检出病原菌316株。革兰阴性杆菌(G-杆菌)206株(65.2%),革兰阳性球菌(G+球菌)62株(19.6%),真菌48株(15.2%),混合感染127例(40.2%),其中革兰阴性杆菌以铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌属多见,且耐药率较高。结论老年卒中患者并发吸入性肺炎在临床较为多见,预后较差,根据其病原学特点合理使用抗菌药物,加强综合治疗,积极防治老年卒中患者吸入性肺炎的发生。Objective To probe into the etiology features of bacterial aspiration pneumonia in elderly patients after stroke.Methods 230 cases of bacterial aspiration pneumonia after stroke during from October 2005 to June 2010 were completely surveyed and analyzed pathogenic characteristics.Results The clinical signs and symptoms of elderly patients with bacterial aspiration pneumonia after stroke were not typical,and diagnosis was difficult.A totle of 316 pathogens were isolated from sputa.There were 206 strains of Gram-negative bacilli（65.2%）,62 strains（19.6%） of Gram-positive cocci,and 48 strains（15.2%） of fungi.The 127 cases（40.2%） were with polyinfections.Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii in Gram-negative bacterias were prevalent,and had higher resistance rates.Conclutions Elderly patients with bacterial aspiration pneumonia after stroke were more common in clinical,and prognosis was poor.According to their pathogenic characteristics,we should use antimicrobial drugs rationally and strengthen integrated treatment to prevent and treat bacterial aspiration pneumonia in elderly patients after stroke.

关 键 词：老年卒中患者 细菌性吸入性肺炎 痰细菌培养 耐药率 

分 类 号：R446.5[医药卫生—诊断学]