老年晚期肿瘤患者重症肺部感染与电解质紊乱的临床治疗  

Clinical treatment on severe pulmonary infection and electrolyte imbalance in elderly patients with advanced tumor

作　　者：张伟红[1] 王丽敏[1] 冯桂青[1] 曹芳丽[1,2] 

机构地区：[1]聊城市人民医院肿瘤科,山东聊城252000 [2]山东大学齐鲁医院化疗科,山东聊城252000

出　　处：《中华医院感染学杂志》2015年第3期608-610,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(ZR2014HL057)

摘　　要：目的探讨老年晚期肿瘤患者重症肺部感染病原学分布、电解质紊乱诊断及治疗方法，提高临床对其诊治水平。方法回顾性分析2012年4月-2013年4月62例晚期肿瘤并发重症肺部感染与电解质紊乱的老年患者临床资料，对其感染病原菌分布、治疗前后的电解质水平及治疗效果进行统计，分析该类患者的诊治方法及效果。结果62例老年晚期肿瘤重症肺部感染患者经对症治疗后，56例患者住院19~28d，平均（23．8±4．2）d痊愈出院；血清钾、钠、氯较治疗前明显提高，与治疗前比较差异有统计学意义（P〈O．05）；4例患者因重症感染致多器官衰竭死亡，2例患者放弃治疗自行出院，治疗总有效率为90．32％。结论老年晚期肿瘤并发重症肺部感染患者容易发生电解质紊乱，患者的病情、病程及预后与电解质紊乱程度呈正相关，因此，不能只重视抗感染治疗，而应同时对电解质紊乱进行纠正，以改善患者的预后。OBJECTIVE To investigate the severe pulmonary infection etiology distribution of elderly patients with advanced tumors, and electrolyte imbalance and its treatment so as to improve clinical diagnosis and treatment of the disease. METHODS The clinical data of elderly patients with late tumor complicated with severe pulmonary infection and etiology distribution were retrospectively analyzed, the infection pathogenic bacteria distribution, electrolyte levels before and after treatment as well as treatment effects were counted, and treatment methods and effects of these patients were analyzed. RESULTS For 62 patients with advanced tumor complicated with severe pulmonary infections, after symptomatic treatment, 56 patients hospitalized 19d to 28d, and were discharged after an average of （23.8±4.2） d. Serum potassium, sodium, chlorine increased significantly compared with pre- treatment, the difference was significant （P〈0.05）. Four patients died of multiple organ failure caused by severe infections, and 2 patients abandoned treatment on their own. The total effective rate was 90.32%. CONCLUSION Elderly patients with advanced tumors complicated with severe pulmonary infection were prone to electrolyte imbalance and the patientrs condition, the degree course and prognosis were positively correlated with electrolyte disorders. Therefore, attention should be paid to both anti-infection treatment and electrolyte imbalance correctness to improve patients＂ prognosis.

关 键 词：老年患者 晚期肿瘤 重症肺部感染 电解质紊乱 诊断 治疗 

分 类 号：R563.1[医药卫生—呼吸系统]