川东北地区重症肺炎的临床特征  

Clinical features of severe pneumonia in northeast sichuan

作　　者：李红兵[1] 王平飞[1] 王廷杰[1] 张雪漫 冉梅[1] 

机构地区：[1]四川省达州市中心医院呼吸内科,635000

出　　处：《重庆医学》2013年第31期3757-3758,3763,共3页Chongqing medicine

摘　　要：目的探讨重症肺炎的临床特征，提高诊治水平。方法回顾性分析2011年不同年龄组重症肺炎患者的基础疾病或并发疾病及相关的主要临床特征。结果临床特征为：（1）随着年龄的增加，老年患者的基础疾病增加，病死或恶化病例也不断增加，4例患者感染人类免疫缺陷病毒（HIV）。（2）起病方式仍以受凉后发病者为主，有40％的患者起病症状表现为神经系统、心脏病及其他呼吸症状。（3）重症肺炎的呼吸衰竭类型主要为1型（约70%），30％的患者需机械通气支持治疗。（4）主要为社区获得性肺炎（75％）。（5）感染菌中，真菌感染及革兰阴性菌的检出率为25％～30％；（6）超过70％的患者不同程度的存在低蛋白血症；（7）治愈好转率占2／3，影响预后的因素有呼吸机依赖、多器官衰竭、复杂感染等。结论认识该地区重症肺炎的特点和治疗难点，有利于提高及时诊治和抢救水平。Objective To learn the clinical features of severe pneumonia in northeast sichuan,and to improve the diagnosis and treatment level. Methods Basic disease or concomitant diseases and it% clinical features were retrospective analyzed in different age patients with severe pneumonia in 2011. Results （1） basic diseases and fatality cases /deteriorated cases were increased in elderly patients with the increase of age. There were 4 patients infected with HIV（3 cases under 65 years old, 1 case over 70 year old）. （2） onset pattern was given first place to suffer from cold, but 40% were showed for symptoms of nervous system,heart disease and other respiratory system; （3）The main respiratory failure types of severe pneumonia is I （about 70%）, 30% of patients needed support of machine ventilation; （4）community pneumonia were main type（75% ） ;detection rate of Fungal infections and G bacteria were 25 %- 30 %, normal bacteria （Streptococcus and Neisser bacteria）were over 1/3, Staphylococcus aureus were about 10 %;（6） More than 70% of the patients with different degree of hypoalbuminemia; （7）Cure accounts for 2/3, poor prognosis accounted for 1/3,in which death and voluntary discharge were each 16.6 %, ventilator-dependent,multi-organ failure, infections and some com- plex social factors were the prognostic factors. Conclusion Understanding the features and treatment difficulty of the local commu- nity acquired pneumonia is helpful to improve the timely diagnosis, treatment and rescue level of patients with severe pneumonia.

关 键 词：重症肺炎 临床特征 川东北 

分 类 号：R563.1[医药卫生—呼吸系统]