老年肺部感染致多脏器功能衰竭的临床特点及预后分析  

Clinical characteristics and prognosis of multiple organ failure caused by pulmonary infection in the elderly

作　　者：晁岳莲 刘浩[1] 穆晓静[1] 高原[1] Chao Yuelian;Liu Hao;Mu Xiaojing;Gao Yuan(Dalian Hospital of Traditional Chinese Medicine,Dalian 116000,China)

机构地区：[1]大连市中医医院,116000

出　　处：《国际医药卫生导报》2018年第23期3609-3612,共4页International Medicine and Health Guidance News

摘　　要：目的 总结分析老年肺部感染致多脏器功能衰竭病例的临床特点,并分析预后情况。方法 回顾性分析本院急重症病房2014年7月至2017年12月间住院的老年肺部感染患者70例,所有患者均具有明确肺部感染,最终出现多脏器功能衰竭(MOEF)。统计总结70例患者基本情况、各系统衰竭情况、并对患者血尿便痰分泌物等标本培养,观察病原菌感染类型。结果 死亡组与治愈组对比,年龄越大、置管越多、基础疾病越多、MOFA评分越高、格拉斯哥评分越低,死亡可能性越大,两组结果比较差异有统计学意义(P<0.05);死亡组与治愈组各系统衰竭比较差异无统计学意义(P>0.05);革兰阴性菌中其他分类的病死率高于治愈率,两组比较差异有统计学意义(P<0.05);白色念珠菌的治愈率高于病死率,两组比较差异有统计学意义(P<0.05)。结论 肺部感染在老年多脏器功能衰竭病程发展过程中具有不可忽视的重要性,可诱发及促进多脏器功能衰竭,导致患者死亡。临床救治肺部感染致多脏器功能衰竭患者应注意患者的基础疾病、辅助治疗措施、MOFA评分、格拉斯哥评分,针对不同类型的脏器衰竭对症治疗,做好病原菌感染类型的分类与抗菌治疗,提高治愈率。Objective To summarize the clinical features and prognosis of multiple organ failure caused by pulmonary infection in the elderly.Methods A retrospective study was performed on 70 elderly patients with pulmonary infection who were hospitalized in the acute and intensive care unit of our hospital between July 2014 and December 2017.All patients had clear lung infection and eventually developed as multiple organ failure.The basic situation of 70 patients and the failure of each system were statistically summarized.At the same time,the patients'blood,urine,stool,sputum secretions were cultured,the type of pathogen infection in patients were observed.Results The death group was compared with the cure group:factors such as older age,more indwelling catheters,more underlying diseases,higher MOFA score,and lower Glasgow score could lead to an increased likelihood of death,with statistically significant differences between the two groups(P<0.05);there were no statistically significant differences in the failure of each system between the death group and the cure group(P>0.05).The rate of other classifications in Gram-negative bacteria infection in the death group was higher than that in the cure group,with statistically significant difference between the two groups(P<0.05).The rate of Candida albicans infection in the cure group was higher than that in the death group,with statistically significant difference between the two groups(P<0.05).Conclusions Pulmonary infection has a significant importance in the development of multiple organ dysfunction in the elderly,which can induce and promote multiple organ failure,lead to death.In the clinical treatment of patients with multiple organ failure caused by pulmonary infection,we should pay attention to the patients'underlying disease,adjuvant treatment,MOFA score,and Glasgow score.In the symptomatic treatment of different types of organ failure,it is necessary to classify pathogen infection types and do antibacterial treatment to improve the cure rate.

关 键 词：老年 肺部感染 多脏器功能衰竭 病原菌 临床特点 预后 

分 类 号：R563.1[医药卫生—呼吸系统]