非ICU患者医院获得性肺炎临床分析  

Clinical characteristics of hospital-acquired pneumonia in non-ICU patients

作　　者：王韧韬[1] 何娓娓[2] 王慧霜[1] 佘丹阳[1] 

机构地区：[1]解放军总医院呼吸内科,北京100853 [2]解放军477医院呼吸科,湖北襄阳441000

出　　处：《中华医院感染学杂志》2013年第6期1265-1267,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解呼吸科非ICU患者医院获得性肺炎(HAP)的临床特点,为临床经验性治疗提供依据。方法回顾性分析2008年9月-2010年9月呼吸科普通病区(非ICU)确诊HAP患者的临床资料,分析发病率、危险因素、病原学特点及治疗3d、治疗终点(EOT)治疗反应、30d死亡率。结果呼吸科(非ICU)出院患者共3229例,HAP发病39例,HAP发病率为1.21%,基础疾病以恶性实体肿瘤最为多见,病原学以鲍氏不动杆菌、铜绿假单胞菌最为多见,治疗3d临床好转24例次,EOT治愈好转22例次,30d归因死亡6例。结论非ICU-HAP患者以多耐药革兰阴性菌感染多见,治疗难度大,死亡率高。OBJECTIVE To understand clinical features of the hospital-acquired pneumonia（HAP） in the patients of non-ICU respiratory department so as to guide the clinical empirical treatment. METHODS The clinical data of the HAP patients who were treated in the non-ICU respiratory department from Sep 2008 to Sep 2010 were retrospectively analyzed, the incidence, risk factors, etiological characteristics, therapeutic reactions at 3rd day, end of therapy, and the 30-day mortality were analyzed. RESULTS A total of 3229 cases of patients were discharged from the non-ICU respiratory departments, among which the HAP occurred in 39 cases with the incidence rate of 1.21%; malignant solid tumor was the most common among the underlying diseases. The main pathogens were Acinetobacter baumannii and Pseudornonas aeruginosa. 24 case-times of patients improved after treatment for 3 days and 22 case-times of patients improved through the end of therapy（EOT）. 6 patients died due to HAP within 30 days. CONCLUSION The multidrug-resistant gram-negative bacteria are the most common pathogens causing infections in the non-ICU patients, which brings great difficulties for the treatment ,and the mortality is high.

关 键 词：医院获得性肺炎 呼吸科 危险因素 多耐药菌 

分 类 号：R181.32[医药卫生—流行病学]