119例高龄患者院内获得性肺炎的临床分析  

Clinical analysis of the characteristics of hospital acquired pneumonia in 119 aged patients

作　　者：黄带发[1] 张丽辉[1] 贺顺川[1] 林朝胜[1] 马雅心[1] 

机构地区：[1]沈阳军区总医院干二科,辽宁沈阳110840

出　　处：《实用临床医药杂志》2012年第15期132-134,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨干部病房高龄患者院内获得性肺炎（hospital acquire pneumonia,HAP）感染的临床特点及干预措施。方法对我科近3年的119例高龄HAP患者的发病原因,细菌分布、耐药情况及预后进行分析。结果①高龄HAP患者痰标本合格率低,细菌耐药发生率高。②住院时间超过3~6月的患者,HAP发生率16.7%,6月以上为44.3%,明显高于住院短于1月的患者（P=0.013,P=0.001）。长期使用广谱抗生素超过3次者,多药耐药发生率达70.0%。③高龄患者HAP感染死亡率6.7%,明显高于我科近5年的住院平均死亡率2.6%（P=0.001）。4.长期带菌而无明显感染症状患者可停抗生素观察。结论干部病房高龄患者长期住院易发生HAP,并且细菌多药耐药发生率高,显著增加患者死亡危险。Objective To explore the clinical characteristics of aged patients with hospital acquired pneumonia（HAP） in veteran officers′ wards and intervention measures.Methods Prognosis of HAP,bacterial distribution and drug resistance of 119 patients from our ward in the past three years were retrospectively analyzed.Results ① The rate of qualified sputum samples was lower and multidrug resistance bacterium was higher.② The incidence of HAP in patients hospitalized 3 to 6 months was 16.7% and that of HAP in those hospitalized over 6 months was 44.3%,higher than those hospitalized less than 1 month（P=0.013,P=0.001）.The rate of multidrug resistance was 70.0% in patients who used long term broad-spectrum antibiotics.③ The mortality（6.7%）in aged patients with HAP was obviously higher than the average mortality（2.6%,P=0.001） of patients hospitalized in our department in recent 5 years.④ It might be safe to cease applying antibiotics in symptomless chronic germ-carrying patients.Conclusion The rates of HAP and multidrug resistance bacterium are high in aged inpatients of veteran officers′ ward,and mortality of these patients increase significantly.

关 键 词：高龄 院内获得性肺炎 多药耐药 

分 类 号：R563.1[医药卫生—呼吸系统]