老年性肺部感染的临床特点分析及诊疗探讨  

Clinical Characteristics and Diagnosis and Treatment of Senile Pulmonary Infection

作　　者：刘小锋 LIU Xiao-feng(Department of Respiratory Medicine,Motou Hospital of Rugao,Rugao 226500,China)

机构地区：[1]江苏省如皋市磨头医院呼吸内科,江苏如皋226500

出　　处：《中国医药指南》2020年第19期83-84,共2页Guide of China Medicine

摘　　要：目的观察老年性肺部感染特点并探讨早期诊断及治疗。方法 2016年1月至2019年2月江苏如皋市磨头医院内科诊治肺部感染患者130例,其中年龄> 60岁的老年患者80例,所占比例61.54%(80/130),中青年肺部感染患者50例,占48.46%(50/130),在明确诊断基础上应用抗生素,重视慢性疾病治疗,纠正缺氧,防止误入,对呼吸衰竭患者选择无创通气治疗,必要时转上级医院治疗。结果老年肺部感染组合并慢性疾病66.25%、非呼吸系统表现47.50%、存在并发症52.50%、误诊漏诊11.25%、中性粒细胞比例≥70%92.50%、治疗时间≥15 d 43.75%、转上级医院治疗10.00%均高于中青年肺部感染组24.00%、12.00%、10.00%、4.00%、64.00%、20.00%、2.00%(χ~2=18.44,14.27,19.30,4.03,13.20,8.44,4.08,P <0.05),白细胞总数≥10.0×109 75.00%低于中青年肺部感染组的86.00%(χ~2=4.25,P <0.05)。结论老年性肺部感染患者与中青年肺部感染患者比较具有一定的特异性,需要仔细观察,尽快明确诊断并及早治疗。Objective To observe the characteristics of senile pulmonary infection and explore the early diagnosis and treatment.Method From January 2016 to February 2019,130 cases of pulmonary infections were diagnosed and treated in Rugao Motou Hospital,Among them,80 cases were older than 60 years old,accounting 61.54%(80/130),there were 50 young and middle-aged patients with pulmonary infection,accounting 48.46%(50/130).On the basis of definite diagnosis,apply antibiotics,pay attention to the treatment of chronic diseases,expectorate sputum,correct hypoxia and prevent errors.,with respiratory failure,should choose non-invasive ventilation therapy and transfer it t a higher hospital if necessary.Result Senile pulmonary infection groupcombined with chronic diseases 66.25%.Non-respiratory manifestations 47.50%.complications52.50%,misdiagnosis and missed diagnosis 11.25%.The proportion of neutrophils more than 70%92.50%.The treatment time over 15 days43.75%patients transferred to higher hospitals 10.00%were higher than those in young and middle-aged pulmonary infection group 24.00%,12.00%,10.00%,4.00%,64.00%,20.00%,2.00%(χ2=18.44,14.27,19.30,4.03,13.20,8.44,4.08,P<0.05).The total number of white blood cells≥10.0×109was lower than that of the young and middle-aged pulmonary infection group(86.00%)(χ2=4.25,P<0.05).Conclusion The elderly patients with pulmonary infection have certain specificity compared with young and middleaged patients with pulmonary infection.It needs careful observation,combined with clinical auxiliary examination,to make a definite diagnosis and early treatment as soon as possible.

关 键 词：老年 肺部感染 特点 临床诊疗 

分 类 号：R563.1[医药卫生—呼吸系统]